食管癌微探头超声内镜与CT扫描诊断价值比较

A comparative study between miniature probe scanner and CT in diagnosis of the esophageal neoplasm

目的 对微探头超声内镜 (MPS)检查与CT扫描诊断食管癌的价值进行比较。方法 5例食管癌术前行MPS检查和CT扫描并与术后病理结果比较。结果 MPS检查能检出所有病例的食管癌病灶 ,包括 1例黏膜层癌及 2例黏膜下层癌 ,癌肿浸润深度诊断准确率 82 % ,诊断纵隔结构受侵准确率 5 0 % ,诊断区域淋巴结转移敏感性 89% ,特异性 78% ,而对纵隔内远处转移的淋巴结均未能探及。CT扫描能发现 83 %的食管癌病灶 ,但不能准确诊断癌肿浸润深度 ,诊断纵隔结构受侵准确率 75 % ,发现区域淋巴结转移敏感性 92 % ,特异性 80 % ,对纵隔内远处淋巴结转移诊断准确率 80 %。结论 MPS检查结合活检是目前食管癌最有价值的腔内检查手段 。

Objective To compare miniature probe scanner with CT in the diagnosis of esophageal neoplasm. Methods MPS and CT were performed in 35 cases of esophaged neoplasm and the imaging results were compared with pathology. Results Focus of esophageal neoplasm in all the cases was detected by MPS, including one case of mucosa cancer and two cases of submucosa cancer. Accurate rate of infiltrate degree was 82%. Accurate rate of invaded structure in mediastina was 50%. Sensitivity sensibility and specificity in metastasis of regional lymph node was 89% and 78%, but none of the metastasis of distant lymph node within the mediastina was found . Focus of esophageal neoplasm cases was detected by CT in 83%, but the infiltrate degree was not detected Accurate rate of invaded mediastinum structure was 75%, sensitivity and specificity in metastasis of regional lymph node was 92% and 80%. Accurate rate of the metastasis of distant lymph node within the mediastinum was 80%. Conclusion MPS combined with biopsy is the most valuable intraluminal examination method for esophageal neoplasm. CT has a more significant role for evaluating the invaded structure and metastasis of distant lymph node within mediastinum.