摘要
目的 :探讨食管癌向周围脏器浸润中的CT诊断标准和应用价值。材料与方法 :34例经手术、病理证实的病例 ,术前行实时螺旋CT扫描。结果 :34例食管中、上段癌19例 ,食管下段癌15例 ;气管、支气管受侵8例 ,主动脉受侵5例 ,心包受侵5例 ,主动脉和心包联合受侵2例 ;34例CT图像中能够明确有食道癌病变31例 ;食管中上段癌17例 ,食管下段癌14例 ;肿瘤与气管、支气管间脂肪层消失9例 ,手术证实8例受侵 ,这9例中邻近病灶上下层面可见脂肪层6例 ,手术证实全部受侵 ;肿瘤与主动脉间脂肪层存在19例 ;脂肪层消失15例 ,其中肿瘤与主动脉接触弧度小于45°6例 ,手术证实均无受侵 ,大于90°2例 ,手术证实均受侵 ,45°～90°之间7例 ,手术证实3例受侵 ;肿瘤与心包间脂肪层消失9例 ,手术证实5例受侵 ,5例受侵病例中邻近病灶上下层面有脂肪层存在3例 ,始终无脂肪层存在2例。结论 :食管癌对气管、支气管和主动脉浸润的CT判定具有较高的准确性 ,而对于心包受累的判定有待于进一步改进和提高 ;
Objective:To discuss the CT diagnostic criteria for the peripheral invasion of esophageal cancer and its clinical value.Material and Method:34 patients proved by surgery and pathology underwent helical CT examination before operation.Result:Of the 34 patients,19 lesions were in the upper segment,and 15 lesions in the lower segment;8 cases with trachea and bronchi invasiveness;5 cases with aorta involved,5 cases with pericardium involvement,and 2 cases with both;CT found 31 lesions,17 of the upper segment,and 14 of the lower segment;9 lesions with unclear fat interval to bronchi,8 were proved to have invasion.Among them,6 cases were found fat interval in the neighboring images,and all were proved invasion.The fat interval between the tumor and aorta was clear in 19 cases,and unclear in 15 cases.6 cases with unclear region were less than 45 degree,all proved uninvolved;2 cases with an angle were over 90 degree,both had invasion,in the left 7 cases,3 had invasion.9 lesions had no fat interval with the pericardium,with 5 were proved invasion.In 3 of them,fat interval was clear in the neighboring images.Conclusion:CT judgement for the invasion of esophageal cancer to the trachea,bronchi,aorta,is with high accuracy,but with low accuracy to the pericardium invasiveness.The CT diagnosis of peripheral invasion of esophageal cancer is of high diagnostic and clinical value.
出处
《中国临床医学影像杂志》
CAS
2000年第6期393-396,共4页
Journal of China Clinic Medical Imaging
