食管癌术前CT检查CT值曲线图及食管腔内造影剂的应用探索

The Use of CT Value Curve Figures of Preoperative CT in Esophageal Carcinoma and Exploring in the Contrast Medium in the Lumen of Esophagus

目的：探索在术前 ＣＴ检查食管瘤时 ＣＴ值曲线图的应用，以及食管腔造影剂的使用，这有助于帮助判别食管壁的厚度以及外侵情况。材料与方法：１００例经过病理学诊断的食管癌病人行ＣＴ检查及分析，把他们随机分成３组以观察不同造影剂的应用显示情况；此１００例病人中，有６５例行了食管癌开胸手术。在ＣＴ值曲线图辅助下使用“三角法”判别主动脉受侵。结果：三种不同的方法显示食管腔都是有价值的，显示满意率分别为８０．００％、８７．８０％以及８２．７６％（Ｐ＞０．０５），显示满意的标准为：①伪影较少；②食管狭窄处的中心可以明确显示。缺乏其中任一项为显示不佳。使用ＣＴ值曲线图、“三角法”判别主动脉受侵的敏感性，特异性及准确性分别为 ８７． ５０％、 ７７． ５６％、 ８０． ００％。结论：食管腔内造影剂的使用对测量管壁厚度是有价值的；ＣＴ值曲线图亦有助于判别主动脉受侵情况。

Purpose: To explore the use of CT value curve figures of preoperative CT in esophageal carcinoma, and the exploration in the contrast medium in the lumen of esophagus in order to help define the thickness of esophageal wall. Materials and Methods: 100 cases with histologic diagnosis of esophageus underwent CT scans examination and analyse and, they were divided into three groups to observe the contrast medium in the lumen of esophagus of the 100 cases, there are 65 cases underwent the thoracotomy with the CT value curve figures 'the triangular method' to determine the aortic invasion is used. Results: Thre methods to show the lumen of esophagus are also helpful. the rate of ideal delineation for three groups is 80. 00 % 、 87. 80 % and 82. 76 %, respectively (P > 0 .05). The criterion of ideal delineation is:①less artifacts. ②The center of the esophageal constriction can be show clearly. Absence of one of the two criteria isn' t ideal, With the CT value curve figures 'the triangular method' to define the aortic invasion the sensitivity, specificity and accuracy of 65 cases were 87. 50 % 、 77. 56 % and 80. 00 %, respectively. Conclusion: the value of use for contrast medium in the lumen of esophagus is high, this can help determined the thickness of esophagus wall; the use of CT value curve figures can help to determine the arctic infiltration.