摘要
目的:探讨CT检查在食管癌术后吻合口瘘诊断中的应用价值。方法:回顾性分析,选择76例食管癌术后患者作为研究对象,时间为2016年1月至2021年3月,整理并分析其临床资料,所有患者均进行胸部CT及上消化道造影检查。比较胸部CT及上消化道造影检查食管癌术后吻合口瘘的结果、胸部CT及上消化道造影检查对食管癌术后吻合口瘘的诊断效能、吻合口瘘与无吻合口瘘CT征象,以及典型病例影像学图片及详细分析。结果:76例食管癌术后患者经临床诊断,阳性32例,阴性44例;经胸部CT检查,阳性30例,阴性46例,其中真实食管癌术后吻合口瘘29例;经上消化道造影检查,阳性29例,阴性47例,其中真实食管癌术后吻合口瘘25例;其中胸部CT检查食管癌术后吻合口瘘的阳性检出率39.47%(30/76),与上消化道造影检查食管癌术后吻合口瘘的阳性检出率38.16%(29/76)相比,差异无统计学意义;在食管癌术后吻合口瘘中,胸部CT检查的特异度、灵敏度、准确度、阳性预测值、阴性预测值高于上消化道造影检查,但两组间经比较,差异无统计学意义(均P>0.05);与无吻合口瘘相比,吻合口瘘中对比剂外漏、纵隔气、积聚集、瘘口显示的患者比例及纵隔内单纯积气最大径平均值较高,差异有统计学意义(均P<0.05),而吻合口瘘与无吻合口瘘中颈前、胸壁积气,纵隔单纯积气,胸腔气、积聚集,胸腔单纯积液的患者比例经比较,差异无统计学意义(均P>0.05)。结论:在食管癌术后患者中,CT检查可在一定程度上提高诊断效能,且通过对比剂外漏、纵隔气、积聚集、瘘口显示征象情况,可有效鉴别吻合口瘘情况。
Objective:To explore the application value of CT examination in the diagnosis of postoperative anastomotic leakage of esophageal cancer,so as to provide a certain reference and basis for the prevention and treatment of postoperative anastomotic leakage of esophageal cancer in the later clinical stage.Methods:For retrospective analysis,76 patients with esophageal cancer after surgery were selected as the research subjects,all of whom were admitted to our hospital from January 2016 to March 2021,and their clinical data were sorted and analyzed.All patients underwent chest CT and Gastrointestinal angiography.To compare the results of chest CT and gastrointestinal angiography in the detection of postoperative anastomotic leakage for esophageal cancer,the diagnostic efficacy of chest CT and gastrointestinal angiography for postoperative anastomotic leakage in esophageal cancer,CT signs of anastomotic leakage with and without anastomotic leakage,and typical Case imaging pictures and detailed analysis.Results:The clinical diagnosis of 76 patients with esophageal cancer was positive in 32 cases and negative in 44 cases;the chest CT examination showed positive in 30 cases and negative in 46 cases,including 29 cases of true esophageal cancer postoperative anastomotic leakage;gastrointestinal angiography In the examination,29 cases were positive and 47 cases were negative,including 25 cases of anastomotic leakage after real esophageal cancer.Among them,the positive detection rate of chest CT examination for postoperative anastomotic leakage of esophageal cancer was 39.47%(30/76),which was the same as that of digestive tract.The positive detection rate of anastomotic leakage after esophageal cancer surgery by angiography was 38.16%(29/76),and the difference was not statistically significant.The degree,positive predictive value and negative predictive value of gastrointestinal angiography were higher than those of gastrointestinal angiography,but there was no significant difference between the two groups(all P>0.05).The proportion of patients with leakage,mediastinal air,accumulation and fistula,and the average maximum diameter of pure air in the mediastinum were higher,and the difference was statistically significant(all P<0.05).There was no significant difference in the proportion of patients with anterior and thoracic pneumatosis,simple mediastinal pneumonitis,pleural gas,accumulation and simple pleural effusion(all P>0.05).Conclusion:In patients with esophageal cancer after surgery,CT examination can improve the diagnostic efficiency to a certain extent,and can effectively identify anastomotic leakage through contrast agent leakage,mediastinal air,accumulation and fistula display signs.
作者
唐贻敏
高修彩
TANG Yi-min;GAO Xiu-cai(Department of Imaging,The Third Affiliated Hospital of Xuzhou Medical University,Jiangsu 221000,China)
出处
《影像技术》
CAS
2022年第4期60-65,共6页
Image Technology
关键词
食管癌
吻合口瘘
电子计算机断层扫描
诊断
应用价值
esophageal cancer
anastomotic leakage
computed tomography
diagnosis
application value
