影像学检查在食管癌诊断中的临床应用

Clinical application of imageology in diagnosis of esophageal neoplasm

目的 :探讨螺旋 CT对食管癌诊断的应用价值。方法 :15例食管癌患者行螺旋 CT增强扫描后多平面重建和 CT仿真内窥镜成像 ,并与其传统 CT轴位图像、X线钡餐造影结果对比。结果 :115例食管癌螺旋 CT增强扫描的轴位图像与传统 CT图像几乎完全相同 ,可以观察病变大小、部位、形态、外周浸润范围和淋巴结转移等情况。 2多平面重建可在不同方位以最佳角度对食管肿瘤进行观察。 15例食管癌 CT仿真内窥镜成像可从头侧或足侧观察食管壁和腔内病变形态 ,获得类似纤维食管胃镜的结果。3X线食管钡餐造影能较好地显示管腔粘膜的改变及癌瘤的长度 ,是普查的重要方法。结论 :螺旋 CT图像较传统 CT图像及 X线钡餐造影为食管癌的术前分期诊断提供了更全面的信息 ,CT仿真内窥镜成像是纤维食管内窥镜的重要补充。

Objective:To evaluate the spiral CT in the diagnosis of esophageal neoplasm by comparing it with conventional CT and barium meal examination.Methods:Spiral CT contrast enhancement scanning and image processing with MPR and CTVE were performed in 15 cases.A comparison was made between the images of spiral CT and the ones of conventional CT and the images of barium meal examination.Results:① On axial images with spiral CT,all lesions of 15 patients showed almost the same pictures as seen with conventional CT.Images clearly showed the position,size,shape of the esophageal neoplasm with local extension and the relation with the adjacent structures as well as lymth node metastases.②MPR could well display esophageal structure through different angle and direction.The appearances of inner wall and lesions on CTVE of esophageal neoplasm were similar to those of fiberaptic endoscopy.③Barium meal examinatiuon was a very effective screening method.Conclusion:Compared with conventional CT and barium meal examination,application of spiral CT provides clinicians with more useful informations. [