术前核磁共振检查对胸段食管癌切除可能性的估计

Preoperative Assessment of Resectability for Thoracic Esophageal Carcinoma by MRI

１９９３年６月～１２月对２６例胸段食管癌病人进行了核磁共振（ＭＲＩ）检查。将ＭＲＩ检查结果、手术及病理进行对比分析，结果表明ＭＲＩ对肿瘤浸润深度及肿瘤是否侵犯胸主动脉、气管、支气管及左心房等重要脏器判断有较大帮助，对于术前切除可能性的准确判断率较高，而对淋巴结转移的准确判断帮助不大。对于早期局限于粘膜及粘膜下层的食管癌不能作出准确的判断。作者认为对术前食管造影长度大于４ｃｍ的胸段食管癌病人可进行ＭＲＩ检查，以了解肿瘤浸润情况，判断切除率。

In order to avoid unnecessary thoracotomy and select appropriate management in patients with esophageal cancer involving a long segment,it is essential to assess the resectability preoperatively,Between June to December,1993,Magnetic Resonance Imaging(MRI)was used to assess the resectablility of the thoracic esophageal carcinoma on 26 patients. The MRI findings were compared with the exploratory findings during the operation. It was proved that MRI was helpful in assessing the depth and extent of the tumor invasion to the adjacent structures or oragns such as aorta,trachea,bronchus and left atrium giving a relatively high accuracy in detecting the resectability of esophageal cancer. However,it is of little value in assessing the lymph node metastasis locally or to the mediastinum,or offers little help in predicting the resectability in an early case where the tumor only invloves the mucosa or submucosal layer.Our clinical data indicate that preoperative MRI should be performed in patients with thoracic esophageal carcinoma of more than 4 cms in length demonstrated by the esophagogram.