三维数字减影技术在食管恶性狭窄诊疗中的应用

Application of 3-dimensional digital subtraction technique in the diagnosing and treating malignant esophageal stenosis

目的探讨三维数字减影技术在食管恶性狭窄病变诊疗中的应用。方法选择晚期食管癌引起的食管恶性狭窄患者40例,口服对比剂后,对其狭窄病变段分别进行三维数字减影检查及二维数字减影检查,并将检查得到的三维数字减影图像与普通食管气钡双重造影片及二维数字减影进行对比分析。结果三维数字减影可以清晰显示食管恶性狭窄的位置,精确测量长度,清晰显示食管癌病灶内的溃疡及穿孔的形态,发现较隐匿的食管瘘,有助于精确定位及选择合适的食管内支架。结论三维数字减影技术对于食管癌恶性狭窄的诊断,病变的精确测量及内支架的有效置放,有着不可替代的作用。

Objective To evaluate 3-dimensional digital subtraction technique in diagnosing and treating the malignant esophageal stenosis.Methods After oral administration of contrast media,both two-dimensional and three-dimensional digital subtraction radiography of narrowed segment of esophagus were performed in forty patients with malignant esophageal stenosis caused by advanced esophageal carcinoma.The images obtained from 3-dimensional digital subtraction technique were compared with the images of the same patient＇s conventional esophageal air-barium double contrast pictures and 2-dimensional digital subtraction pictures.The results were analyzed.Results Three-dimensional digital subtraction images could well display the position of the malignant esophageal stenosis.On the images the lesion＇s length could be precisely measured,the lesion＇s ulcer and perforation shape could be clearly demonstrated,and subtler esophageal fistula could be detected,which was very helpful for accurately localizing the lesion and selecting suitable endo-esophageal stent.Conclusion The 3-dimensional digital subtraction technique is very useful in diagnosing malignant esophageal stenosis.With the help of the 3D images the lesion can be precisely localized and the suitable esophageal stent can be effectively selected and placed.