中晚期食管癌CT检查及其征像分析

MID-ADVANCED CARCINOMA OF ESOPHAGUS:CT FINDINGS AND ITS ANALYSIS

目的分析中晚期食管癌及其扩展的CT表现。方法回顾性研究1993年1月至1995年11月间在我院做CT检查的38例中晚期食管癌病人。结果食管癌CT表现:①肿瘤显示:食管壁增厚>5mm,Moss和Halversen标准及软组织肿块形成;②食管癌的扩展:主动脉侵犯(picus标准)、奇静脉及心包侵犯;气管和支气管侵犯,呈管腔后壁内凸、不规则,管壁增厚,管腔不规则狭窄及瘘道形成,提出气管受侵的"气管食管旁沟填塞征";食管纵隔瘘伴纵隔炎症;淋巴结转移(包括纵隔、颈部及腹腔淋巴结);血行转移。结论术前CT检查对食管癌分期、可切除性及预后估计评价都十分重要。

Objective To analyse CT findings in mid-advanced esophageal carcinoma together with its tumor extent. Method CT scan of 38 patients with mid-advanced carcinoma of esophagus from January 1993 to December 1995 was stud- ied. Results CT findings revealed: ①thickened esophageal wall (>5mm, Moss and Halversen's standard) and formed soft- tissue mass; ②tumor extent: Invasion of aorta (Picus's standard), vena azygos and pericardiacae; invasion of tracheobronchial tree, including convex bowing inward and irregular infiltration of the posterior wall of the tracheobronchi, thickening of the wall, irregular narrowness of the lumen and fistula formation. Here, a 'filled tracheoesophageal side-groove' should be re- garded as a sign of tracheal invasion as suggested by authors; Mediastinitis accompanied with esophago-mediastinal fistula; Lymph nodes, including those in neck, mediastinum and abdomen, involved; Distant metastases. Conclusion Preoperative CT scan of esophageal carcinoma was thought to be important for evaluation of staging, resectability and prognosis.