食管癌对纵隔脏器浸润低张水充盈的CT与手术病理对照

Comparative Between CT with Hypotonic Water-filling Method and Pathology of Esophageal Carcinoma with Mediastinum Viscera Invasion

目的:探讨低张食管水充盈法CT检查对食管癌浸润纵隔脏器的诊断标准和应用价值。方法:80例经胃镜活检和手术病理证实的病例,术前行低张食管水充盈法CT扫描。结果:本组80例食管胸上段癌16例,胸中段癌41例,胸下段癌23例。气管、支气管受侵18例,主动脉受侵26例,心包受侵13例,主动脉和心包联合受侵5例;低张食管水充盈图像清晰显示食管原发病变与气管、支气管、主动脉,心包间的关系。80例CT图像中能够明确有食管癌病变77例;胸上段癌15例,胸中段癌40例,胸下段癌22例;肿瘤与气管,支气管间脂肪间隙消失19例;肿瘤与主动脉间脂肪间隙消失36例。肿瘤与心包间脂肪间隙消失16例。结论:低张食管水充盈法CT检查在食管癌对气管、支气管和主动脉浸润的判定具有较高的准确性,而对心包是否受累的判定明显比非低张检查准确度高;低张食管水充盈法CT检查在诊断食管癌向纵隔脏器浸润具有较高价值和临床意义。

Objective: To evaluate the diagnostic standard and clinical value of the CT scan with water-filling method in esophageal carcinoma with mediastinum viscera invasion. Method: CT scan with water-filling method were performed in 80 cases with esophageal carcinoma with mediastinum viscera invasion before surgery. CT findings were compared with histopathologic studies of the resected specimen. Result: Of all 80 cases ,18 cases were in segment superior, 41 cases in segment medius and 23 cases in segment inferior; 18 with Trachea or bronchus invasion, 26 with aortas invasion, 13 with pericardium invasion, 5 with both aortas and pericardium invasion. 77 of 80 cases could be diagnosed definitely by CT scan with water-filling method, and the relationship between carcinoma and mediastinum viscera around it was clearly. Conclusion: CT scan with water-filling method is much better than general CT in telling esophageal carcinoma with or without mediastinum viscera invasion, especially in telling pericardium invasion. The clinical value is significant.