食管癌术后吻合口复发的增强MDCT诊断

The enhancement MDCT diagnosis of anastomotic recurrence after esophagectomy

目的探讨增强MDCT诊断食管癌术后吻合口复发的临床应用价值。方法回顾性分析经胃镜病理证实的74例食管癌术后的增强MDCT扫描资料,依据CT征象及病理结果分为3组,A组为正常吻合口组(n=28),B组为吻合口良性增厚组(n=22),C组为吻合口恶性增厚组(n=24),对比分析三组病例吻合口相关征象。结果 1)吻合口区管壁厚度及动脉期强化幅度对于鉴别吻合口情况具有一定意义(P<0.05);2)狭窄段粘膜中断相关性较高(偏心型增厚、管腔肿块、不均匀强化、增厚的管壁上下缘不规则、狭窄段粘膜中断、动脉期强化幅度与吻合口恶性增厚均有一定相关性),而增厚管壁强化环及静脉期强化幅度对吻合口良、恶性增厚的鉴别无统计学意义。结论增强MDCT对食管癌术后吻合口复发情况的诊断具有较高的临床应用价值。

Objective To explore the clinical value of enhancement MDCT diagnosis of anastomotic recurrence after esophagectomy. Methods We conduct a retrospective analysis of the enhancement MDCT scan document of 74 cases of postoperative esophageal cancer proved by endoscopic pathology. It is divided into 3 groups according to CT sign and pathological results. Group A is normal anastomosis （n = 28 ）. Group B is anastomotic benign thickening （ n = 22 ） and group C is anastomotic malignant thickening （n = 24）. A comparative analysis on relevant signs of three groups is performed. Results 1 ） The thickness of the tube wall and the enhancement of the arterial phase in the anastomotic area have certain significance to identify anastomosis （ P 〈 0. 05） ; 2） Mucosal disruption in the narrow segment is relatively high （ eccentric thickening, lumen mass, inhomogeneous enhancement, irregular upper and lower edge of pipe wall of thickening, mucosal disruption in the narrow segment, arterial phase enhancement amplitude have certain relevance with malignant thickening of the anastomosis）, while thickening of the wall of the ring and the enhancement of venous phase have no statistical significance to the identification of benign and malignant thickening. Conclusion The enhancement MDCT has higher clinical value to the diagnosis of postoperative anastomotic recurrence of esophageal carcinoma.