中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2015年
11期
132-134,138
,共4页
螺旋CT%食管癌%术前分期
螺鏇CT%食管癌%術前分期
라선CT%식관암%술전분기
Spiral CT%Esophageal cancer%Preoperative staging
目的：分析多层螺旋CT扫描在食管癌术前分期评估中的应用价值。方法回顾性分析我院2011年1月~2014年1月收治的食管癌患者38例的临床资料，分析38例食管癌患者MSCT检查显示管壁的厚度、肿瘤的外侵程度、有无淋巴结及远处脏器的转移，并对38例食管癌术前CT分期与术后病理对照进行分析。结果38例食管癌患者中鳞癌32例，CT表现为食管管壁环形增厚6例，食管腔内肿块4例，管壁偏心不规则增厚22例(食管局部厚度为5~55 mm，其中管壁增厚0.5~1.0 cm 3例，1.1~2.0 cm 16例，2.1~3.0 cm 2例，>3.0 cm 1例)，2例为早期食管癌，CT未见阳性表现，4例未见明显增强征象。21例管腔出现狭窄，狭窄的食管壁边缘僵硬而不规则，呈环状狭窄，4例管腔闭塞。18例食管周围脂肪间隙消失。4例气管受压变形，3例左主支气管变窄、移位，1例食管支气管瘘。38例食管癌患者术前行CT检查，根据Moss分期分为Ⅰ期3例、Ⅱ期6例、Ⅲ期25例、Ⅳ期4例。其中癌侵犯主动脉1例，侵犯气管2例，并发肝转移2例，肺转移1例。10例出现淋巴结转移，大部分增大淋巴结均有强化，少部分淋巴结中心坏死，边缘强化。淋巴结大小为15~30 mm。结论多层螺旋CT扫描在食管癌术前分期评估中具有重要价值，有助于选择合适的手术方案。
目的：分析多層螺鏇CT掃描在食管癌術前分期評估中的應用價值。方法迴顧性分析我院2011年1月~2014年1月收治的食管癌患者38例的臨床資料，分析38例食管癌患者MSCT檢查顯示管壁的厚度、腫瘤的外侵程度、有無淋巴結及遠處髒器的轉移，併對38例食管癌術前CT分期與術後病理對照進行分析。結果38例食管癌患者中鱗癌32例，CT錶現為食管管壁環形增厚6例，食管腔內腫塊4例，管壁偏心不規則增厚22例(食管跼部厚度為5~55 mm，其中管壁增厚0.5~1.0 cm 3例，1.1~2.0 cm 16例，2.1~3.0 cm 2例，>3.0 cm 1例)，2例為早期食管癌，CT未見暘性錶現，4例未見明顯增彊徵象。21例管腔齣現狹窄，狹窄的食管壁邊緣僵硬而不規則，呈環狀狹窄，4例管腔閉塞。18例食管週圍脂肪間隙消失。4例氣管受壓變形，3例左主支氣管變窄、移位，1例食管支氣管瘺。38例食管癌患者術前行CT檢查，根據Moss分期分為Ⅰ期3例、Ⅱ期6例、Ⅲ期25例、Ⅳ期4例。其中癌侵犯主動脈1例，侵犯氣管2例，併髮肝轉移2例，肺轉移1例。10例齣現淋巴結轉移，大部分增大淋巴結均有彊化，少部分淋巴結中心壞死，邊緣彊化。淋巴結大小為15~30 mm。結論多層螺鏇CT掃描在食管癌術前分期評估中具有重要價值，有助于選擇閤適的手術方案。
목적：분석다층라선CT소묘재식관암술전분기평고중적응용개치。방법회고성분석아원2011년1월~2014년1월수치적식관암환자38례적림상자료，분석38례식관암환자MSCT검사현시관벽적후도、종류적외침정도、유무림파결급원처장기적전이，병대38례식관암술전CT분기여술후병리대조진행분석。결과38례식관암환자중린암32례，CT표현위식관관벽배형증후6례，식관강내종괴4례，관벽편심불규칙증후22례(식관국부후도위5~55 mm，기중관벽증후0.5~1.0 cm 3례，1.1~2.0 cm 16례，2.1~3.0 cm 2례，>3.0 cm 1례)，2례위조기식관암，CT미견양성표현，4례미견명현증강정상。21례관강출현협착，협착적식관벽변연강경이불규칙，정배상협착，4례관강폐새。18례식관주위지방간극소실。4례기관수압변형，3례좌주지기관변착、이위，1례식관지기관루。38례식관암환자술전행CT검사，근거Moss분기분위Ⅰ기3례、Ⅱ기6례、Ⅲ기25례、Ⅳ기4례。기중암침범주동맥1례，침범기관2례，병발간전이2례，폐전이1례。10례출현림파결전이，대부분증대림파결균유강화，소부분림파결중심배사，변연강화。림파결대소위15~30 mm。결론다층라선CT소묘재식관암술전분기평고중구유중요개치，유조우선택합괄적수술방안。
Objective To analyze the application value of multislice spiral CT in preoperative staging evaluation of esophageal carcinoma. Methods Retrospective analyzed the clinical data in our hospital from January 2011 to January 2014 of 38 cases of esophageal cancer patients, analyzed 38 cases of esophageal cancer patients underwent MSCT ex-amination and showed that the pipe wall thickness, tumor invasion degree, lymph node and distant organ metastasis. In 38 cases of esophageal carcinoma and CT staging of preoperative and postoperative pathology were analyzed. Results 32 cases of squamous cell carcinoma of 38 esophagus cancer patients, CT showed 6 cases of esophageal wall thicken-ing, 4 cases of esophageal intraluminal masses, irregular eccentric tube wall thickening in 22 cases (esophageal partial thickness was 5-55 mm, the tube wall thickening in 0.5-1.0 cm three cases, 1.1-2.0 cm in 16 cases, 2.1-3.0 cm in 2 cases, >3.0 cm one case), 2 cases of early esophageal cancer, no CT positive expression, 4 patients had no obvious enhancement features. In 21 cases the lumen appeared stenosis, esophageal wall edge stiff narrow and irregular, annu-lar stenosis, 4 cases of occlusion of the lumen. In 18 cases of esophageal surrounding fat space disappeared. 4 cases of tracheal compression deformation, left main bronchial narrowing, transposition in 3 cases, including 1 case of esophageal and bronchial fistula. In 38 patients with carcinoma of esophagus CT examination before operation, accord-ing to the Moss staging for stage Ⅰ 3 cases, stage II 6 cases, stage Ⅲ 25 cases, stage Ⅳ 4 cases. The cancer invad-ing aorta in 1 case, 2 cases with tracheal invasion, 2 cases complicated with hepatic metastasis, lung metastasis in 1 case. 10 cases of lymph node metastasis, most of enlarged lymph nodes were strengthened, few lymph node necrosis in the center, edge enhancement. Lymph node size of 15-30 mm. Conclusion Multi slice spiral CT scanning in staging e-valuation has an important value in esophageal carcinoma before operation, helps to select the suitable operation scheme.
