食管癌对纵隔脏器浸润低张水充盈的CT与手术病理对照.DOCVIP

临床医学论文-食管癌对纵隔脏器浸润低张水充盈的CT与手术病理对照 【关键词】? 食管癌 　　摘要：目的：探讨低张食管水充盈法CT检查对食管癌浸润纵隔脏器的诊断标准和应用价值。方法：80例经胃镜活检和手术病理证实的病例，术前行低张食管水充盈法CT扫描。结果：本组80例食管胸上段癌16例，胸中段癌41例，胸下段癌23例。气管、支气管受侵18例，主动脉受侵26例，心包受侵13例，主动脉和心包联合受侵5例; 低张食管水充盈图像清晰显示食管原发病变与气管、支气管、主动脉，心包间的关系。80例CT图像中能够明确有食管癌病变77例; 胸上段癌15例，胸中段癌40例，胸下段癌22例；肿瘤与气管，支气管间脂肪间隙消失19例；肿瘤与主动脉间脂肪间隙消失36例。肿瘤与心包间脂肪间隙消失16例。结论：低张食管水充盈法CT检查在食管癌对气管、支气管和主动脉浸润的判定具有较高的准确性，而对心包是否受累的判定明显比非低张检查准确度高；低张食管水充盈法CT检查在诊断食管癌向纵隔脏器浸润具有较高价值和临床意义。 　　关键词：低张食管水充盈；食管肿瘤；体层摄影术；X线计算机 　　Comparative Between CT with Hypotonic Water-filling Method and Pathology of Esophageal Carcinoma with Mediastinum Viscera Invasion 　　　Abstract： Objective: To evaluate the diagnostic standard and clinical value of the CT scan with water-filling method in esophageal carcinoma with mediastinum viscera invasion.?Method: CT scan with water-filling method were performed in 80 cases with esophageal carcinoma with mediastinum viscera invasion before surgery. CT findings were compared with histopathologic studies of the resected specimen. Result: Of all 80 cases ,18 cases were in segment superior, 41 cases in segment medius and 23 cases in segment inferior; 18 with Trachea or bronchus invasion, 26 with aortas invasion, 13 with pericardium invasion, 5 with both aortas and pericardium invasion. 77 of 80 cases could be diagnosed definitely by CT scan with water-filling method, and the relationship between carcinoma and mediastinum viscera around it was clearly. Conclusion： CT scan with water-filling method is much better than general CT in telling esophageal carcinoma with or without mediastinum viscera invasion, especially in telling pericardium invasion. The clinical value is significant. 　　Key words: Hypotonic water-filling method; Esophageal carcinoma; Tomography；X ray computer????????????????????????????????????????????????????????????????????????????????? 　　食管癌是一预后较差的消化道恶性肿瘤，食管癌患者出现症状诊断时绝大多数已成为进展期癌，为提高食管癌治疗效果，术前评价对于外科手术与否及手术方案的制定至关重要。低张食管水充盈法CT扫描是食管癌术前评价较理想的影像检查手段。低张食管充水可使食管腔充分扩张，清晰地显示增厚食管壁和狭窄的管腔以及纵