Characteristic analysis of Zenker’s diverticulum incidentally detected on multimodal neck ultrasound

• Published in: Journal of medical ultrasonics (2001) 2020-04, Vol.47 (2), p.279-285
• Main Authors: Huang, H. J., Chen, R., Sheng, J. G., Cao, K. K., Zhao, J. Q.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Barium; Blood flow; Contrast agents; Contrast Media; Diagnosis; Diagnosis, Differential; Diverticulitis - diagnostic imaging; Diverticulum; Esophagus; Esophagus - diagnostic imaging; Female; Humans; Image Enhancement - methods; Imaging; Imaging, Three-Dimensional - methods; Incidental Findings; Lesions; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Multimodal Imaging - methods; Neck; Original Article–Gastroenterology; Patients; Radiology; Retrospective Studies; Sonograms; Swallowing; Three dimensional flow; Thyroid diseases; Thyroid gland; Ultrasonic imaging; Ultrasonography - methods; Ultrasonography, Doppler, Color - methods; Ultrasound; Zenker Diverticulum - diagnostic imaging
• ISSN: 1346-4523; 1613-2254
• DOI: 10.1007/s10396-019-00992-w

Purpose Zenker’s diverticulum (ZD) incidentally detected on neck ultrasound (US) could be easily misdiagnosed as a thyroid nodule and unnecessarily removed by surgical operation. It is a critical issue to identify the characteristics of ZD in clinical practice. Methods We reported 10 cases of ZD diagnosed using multimodal US, and discussed the features of its multimodal US images extracted from grayscale sonograms, color Doppler flow imaging (CDFI), three-dimensional US (3D-US), and contrast-enhanced US (CEUS). Results All lesions were heterogeneous in the posterior of the left thyroid. CDFI showed no blood flow within the lesions. The shapes and internal echoes of the masses changed when patients swallowed or drank. Performing CEUS or 3D-US for those with atypical US findings was complementary to make the final diagnosis. Importantly, multimodal US helped to diagnose suspected small lesions in three cases in which the barium esophagram tests proved negative. Conclusions The US features of ZD detected by multiple modes of US can help in the collection of comprehensive imaging information on ZD, which should be used proactively to facilitate the correct diagnosis and to avoid misdiagnosis of ZD.