Can we make an accurate diagnosis of pyriform sinus fistula by fetal MRI?

Zeng, Shaohua; Liu, H.S.; Zhong, Wei; Liu, Z.Q.; He, Qiuming; Han, Jin Hee; Wang, Z.

doi:10.1016/j.crad.2016.05.012

Cited by 7 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A variety of imaging modalities 3,5,[11][12][13][14][15][16] have been described for the diagnosis of congenital pyriform sinus fossa (CPSF) anomalies, including ultrasound, barium studies, computed tomographic (CT) scans, and magnetic resonance imaging (MRI) scans. Barium esophagography most clearly depicts the presence and course of the fistula, 3,11,12 but a false-negative result may occur during the inflammatory period.…”

mentioning

confidence: 99%

MRI in Children With Pyriform Sinus Fistula

Han

Tai

Gao

et al. 2020

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Background A variety of imaging modalities have been described for the diagnosis of congenital pyriform sinus fistula (CPSF). To date, there have been few MRI reports. Purpose To evaluate MRI findings of CPSF and interobserver reliability. Study Type Retrospective. Population In all, 115 patients aged 23 days to 15.4 years at operation. Field Strength/Sequence 3.0T/axial T1‐weighted image (T1WI)‐SPIR, axial T2WI, axial T2WI‐STIR, coronal T2WI‐SPIR, diffusion‐weighted imaging (DWI), axial and coronal gadolinium‐enhanced T1WI‐SPIR. Assessment For each patient, the medical records, including demographics, clinical manifestations, and MRI findings were reviewed. All the MRI studies were interpreted by three radiologists independently. Statistical Test Kendall's W test was made to determine the interobserver reliability of three reviewers for MRI findings. Results CPSF occurred on the left side in 104 (90.4%) patients and on the right side in 11 (9.6%) patients. The male‐to‐female ratio was 59:56. The age at first episode varied from birth to 12.3 years. There was one neonate patient, who presented with a unilocular cystic mass in the left neck. A tunnel‐like lesion between the pyriform fossa and the upper pole of the thyroid gland, T2 high signal behind the cricothyroid joint, thyroid gland involvement, deep neck abscesses or masses were noted in 46 (40%), 93 (80.9%), 96 (83.5%), and 36 (31.3%) patients, respectively. There was excellent interobserver reliability for all the MRI findings, ranging from 0.84 to 1.00. Data Conclusion The sinus tract presenting with a tunnel‐like lesion goes behind the cricothyroid joint in most cases. For patients presenting with acute suppurative thyroiditis (AST) or neck infection with thyroid gland involvement, the presence of T2 high signal behind the cricothyroid joint highly suggests the diagnosis of CPSF. MRI is a reliable method for the diagnosis of CPSF. Level of Evidence 4 Technical Efficacy Stage 2

show abstract

mentioning

confidence: 99%

MRI in Children With Pyriform Sinus Fistula

Han

Tai

Gao

et al. 2020

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…However, the diagnosis of fetal PSF remains a great challenge for radiologists due to the small cyst size. This review revealed 23 cases with a prenatal diagnosis of PSF (6,7,9,24,32,54). PSF-related neck abnormality is often identified in the second or third trimester.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, neck masses and respiratory problems are the main presentations in neonates with PSF, and tracheal compression may lead to apnea. Therefore, the diagnosis of PSF in the fetus and neonate has been widely acknowledged as a growing concern (6)(7)(8)(9)(10). In addition to the clinical presentations, the preferred imaging test between children and neonates is also quite different (11).…”

Section: Introductionmentioning

confidence: 99%

Pyriform Sinus Fistula in the Fetus and Neonate: A Systematic Review of Published Cases

Chen

Sheng

et al. 2020

Front. Pediatr.

View full text Add to dashboard Cite

Purpose: To provide recommendations for the diagnosis and treatment of pyriform sinus fistula (PSF) in the fetus and neonate through a systematic review of the published literature. Methods: PubMed and Embase (1968-2019) were searched, and additional publications were obtained by searching the references by hand. The two reviewers assessed all papers and extracted the following variables: demographics, clinical features, diagnostic tests, interventions, and prognoses. Results: Forty-two papers were included, comprising a total of 158 cases. PSF presented almost exclusively on the left side (95.56%). Patients usually presented with a neck mass (100%) and respiratory distress (43.18%). The false-negative rate (FNR) of prenatal ultrasonography (US) was significantly higher than that of prenatal magnetic resonance imaging (MRI) (P < 0.01). For the diagnosis of PSF in neonates, computerized tomography (CT) and MRI were the most accurate diagnostic modalities. Ex utero intrapartum treatment (EXIT) was performed during delivery in 6 patients (26.09%). Among 135 patients with a reported date of definitive surgery, 117 (86.67%) underwent surgery during the neonatal period. Complications after definitive surgery appeared in 5 patients (3.16%), and all of them recovered spontaneously within 3 months. Furthermore, recurrence occurred in 4 patients (2.53%). Conclusion: In fetal cases with PSF suspected by US, MRI is necessary to confirm the diagnosis. During the neonatal period, patients with PSF typically present with a neck mass and respiratory distress, and CT/MRI appears to be the preferred diagnostic method. Definitive surgery is effective for treating neonatal PSF, with a low complication rate and low recurrence rate.

show abstract

“…The airway patency should be assessed if the cyst is relatively large or growing. MRI appears to be better than ultrasonography in the prenatal evaluation of airway obstruction, which is most likely due to the image contrast of the MRI . At least one MRI should be performed to reassess the airway before delivery (Figure ).…”

Section: Discussionmentioning

confidence: 99%

“…MRI appears to be better than ultrasonography in the prenatal evaluation of airway obstruction, which is most likely due to the image contrast of the MRI. 11,12 At least one MRI should be performed to reassess the airway before delivery (Figure 2). If MRI reveals a shifted or surrounded trachea, airway obstruction should be alerted.…”

Section: Prenatal Diagnosis and Multidisciplinary Evaluationmentioning

confidence: 99%