食道CT三维重建在食道异物围手术期的价值

The value of multi-slice CT 3D reconstruction in perioperative esophageal foreign body

目的探讨食道CT三维重建在食道异物的诊断，术前评估及术后判断并发症治愈的作用及意义。方法回顾性分析我院2007年2月至2012年11月收治5l例食道异物患者，行食道CT三维重建检查以了解异物及其种类、位置、大小，数量、与食道壁关系、有无食道穿孔及周围感染等，选择手术方式治疗；术后并发症患者经治疗后复查判断患者恢复情况。结果50例患者成功取出异物；根据CT检查结果分别采取纤维胃镜，硬食道镜，颈侧切开及胸外进路不同的手术；穿孔及周围脓肿患者术后经综合治疗2周后，复查CT显示食道管壁周围软组织影或气泡影消失。结论食道CT三维重建检查在食道异物围手术期有很高的临床价值。表现在：①对异物诊断有很高的敏感性；②为术前评估提供依据，选择最佳的手术方式；③为并发症治愈提供较可靠的影像标准。

Objective To investigate the role and significance of the esophagus CT 3D reconstruction in the diagnosis of esophageal foreign body, evaluation of preoperative and judgment of postoperative complications after treats. Methods In a retrospective review of 51 cases esophageal foreign body of our hospital in 2007 . 2-2012 11. the CT 3D reconstructions were checked to dedect the foreign body and its description, location, size, quantity, relationship with esophagus, esophageal perforation and infection, based on these, we selected the best surgical treatment; patients with complications after operation were reviewed to judge the recovery. Results 50 patients were successfully removed the foreign body; according to the images of the CT scan, the ways though fiber gastroscopy, hard esophagoscopy, lateral neck incision and chest surgical approach were taken to different person, respectively; the abnormal shadows around esophagus disappeared in CT of the patients with compications after two-week treat. Conclusion SCT 3D reconstruction in esophageal foreign body had high value in perioperative, including： high sensitivity for foreign body; the basis for the preoperative assessment; a better imaging standards for complications were cured.