多层螺旋CT三维重建对复杂食管异物手术的指导价值

The guidance values of multislice spiral CT 3D reconstruction in surgical options of complicated esophageal foreign bodies

目的探讨多层螺旋CT(MSCT)三维重建对复杂食管异物手术的指导价值。方法对25例临床诊断或疑诊为食管异物的患者进行MSCT扫描三维重建检查,根据其表现评估食管及周围组织侵犯情况,预测手术方式,并与手术结果对照。结果MSCT检查发现:19例为食管异物,其中14例行硬质食管镜取异物取出术、5例颈侧切开或开胸术异物取出术;6例排除食管异物。MSCT显示的19例食管异物,均在术中证实。MSCT诊断与手术的符合率为100%。结论MSCT扫描三维重建有利于观察食管异物的特征,位置和周围的关系。有助于预测食管异物的手术方式。避免了手术的盲目性。为硬质食管镜检查、开胸手术及颈侧切开术前评估提供了一种新的评估手段。

Objective To investigate the guidance values of multi-slice spiral CT with three-dimention（3D） Reconstruction on Surgical options of complicated esophageal foreign bodies. Methods 25 patients with clinical diagnosis or suspicious for esophageal foreign bodies were examined by the MSCT with 3D reconstruction. The way of operation which was compared with surgical results, was predicted by evaluating violations of the esophagus and surrounding tissues according to image of 3D reconstruction. Results 6 patients excluded esophageal foreign bodies by the follow-up therapy. 19 patients were confirmed as esophageal foreign bodies; 14 cases were carried out with rigid esophagoscopy surgery, and 5 cases with lateral neck incision or thoracotomy. All the 19 cases of esophageal foreign bodieswere confirmed by surgery. Conclusion MSCT with 3D reconstruction is conducive to observation of the characteristics of esophageal foreign bodies, location and surrounding tissues. It is helpful to predict surgical options to remove esophageal foreign bodies and avoid blindness surgery. It is a new means of preoperative evaluation for foreign body removal by rigid esophagoscopy, lateral neck incision or thoracotomy.