胸段食管癌淋巴结转移分布特征的螺旋CT表现

CT features of lymph node metastases of thoracic esophageal carcinoma

目的:探讨胸段食管癌颈胸腹部三野淋巴结转移的分布特征及其螺旋CT表现。资料与方法:对200例手术病理证实为胸段食管癌的CT资料进行回顾性分析,所有病例均经手术病理证实或影像标准诊断有淋巴结转移。根据本组200例CT所反映的肿大淋巴结的分布情况,将颈胸腹部三野淋巴结分为19组。设定淋巴结的短径≥1cm为淋巴结转移阳性标准,统计各组阳性淋巴结的出现率,观察淋巴结转移的位置、形态、大小、数目及强化情况。结果:200例食管癌中,共有546个部位观察到淋巴结转移。食管癌的淋巴结转移以右下气管旁组(40.0%,80例)、主肺动脉窗组(34.0%,68例)、隆突下组(27.0%,54例)最多,膈上组(2.5%,5例)及脾动脉组(1.5%,3例)最少。结论:食管癌淋巴结转移主要分布在右下气管旁组、主肺动脉窗组及隆突下组。螺旋CT检查可以较为准确地显示食管癌三野淋巴结的转移情况。

Objective： To explore the CT features and distribution characteristics of lymph node metastases of neck, medi- astinum and abdomen in patients with thoracic esophageal carcinoma. Methods： To analyse the CT materials of 200 cases of histopathologically proved esophageal cancer retrospectively with three fields of lymph node metastases. The CT imaging criteria of lymph node metastases are maximum short axis diameter of lymph node equal to or larger than lcm. According to the lymph node location, the three fields of lymph node were classified as 19 groups. CT imaging was evaluated with special at- tention to the location, shape, size, number and enhancement. Results： The lymph node metastases of three fields were ob- served mainly around the fight inferior paratracheal nodes（40.0%）, the aorticopulmonary window nodes（34.0%）, and the inferior tracheal bifurcation nodes（27.0%）. The posterior crural nodes（2.5%）, and the splenic nodes（1.5%） were the least location where metastases occurred. Conclusion： Lymph node metastases of thoracic esophageal carcinoma are mainly located around the right inferior paratracheal nodes, the aorticopulmonary window nodes and the inferior tracheal bifurcation. CT imaging can clearly re- veal the location of lymphadenopathy in patients with esophageal carcinoma.