食管癌治疗后纵隔淋巴结转移的X线分析

X-ray Analysis of Mediastinal Metastases in Esophageal Carcinoma after Therapy

目的 :评价胸部正侧位及食管造影对食管癌纵隔转移的诊断价值。方法 :摄常规胸正位片 ,必要时加胸侧位片 ,透视下行正位、双斜位食管造影点片。结果 :胸片表现 :① 上纵隔增宽 ,结节状弧形突出 ;② 气管局限性受压 ,不对称性狭窄 ,移位 ;③ 气管分叉下浓密 ,分叉角变大 ,主支气管受压变窄 ;④ 肺门增大 ,呈结节状 ,血管边缘模糊不清 ;伴有阻塞性肺炎、含气不全或肺不张。食管造影表现 :①食管或胸胃偏侧性半弧形压迹 ,管腔不对称狭窄 ;② 食管或气管旁结节状 ,偶见气管后带局限性增厚 ;③患侧吞咽活动差 ,梨状窝不对称 ,钡剂误入气管。结论 :胸部平片正侧位及食管造影检查对食管癌纵隔淋巴结转移有一定的诊断价值。

Objective:To evaluate the X ray diagnosis in mediastinal metastases of esophageal carcinoma.Methods:Take chest plain film,or side film if necessary.Spot anteropostertior,right and left oblique position esophagram under fluoroscopy.Results:Chest plain films:①Superior mediastinum widened,enlarged node was seen.②The trachea was pressed locally and shifted to the other side,the cavity became asymmetrically narrow.③Nodes could be seen in the subcarinal location,tracheobronchia was pressed and became narrow.④Enlarged nodes could be seen at the hilar regions,sometimes followed with atelectasis or obstructive pneumonia.Esophagram:①The esophageal stump or intrathoracic stomach was pressed by nodular shadow unilaterally,and the cavity became narrow.②Nodes were usually found clinging to the trachea or esophagus,sometimes the retrotracheal band thickened only.③Asymmetric swallowing,the piriform recess was metamorphosed,and barium flowed into the tracheobronchial.Conclusion:Esophagography is a useful examination in diagnosis in mediastinal metastases of esophageal carcinoma after therapy.