螺旋CT对胸段食管癌淋巴结转移的诊断价值

 目的　分析螺旋CT对胸段食管癌淋巴结转移的诊断价值，探讨食管癌转移淋巴结的分布规律。方法　117例经手术病理证实的食管癌患者术前行CT扫描，判断是否存在淋巴结转移，评估CT对胸段食管癌淋巴结转移的诊断价值；重点观察记录CT、病理同时检出的74例食管癌患者转移淋巴结的分布特征。结果　CT对117例食管癌患者淋巴结转移诊断的灵敏度、特异度、准确度分别为86.0 %、80.6 %、84.6 %。食管癌转移淋巴结胸上段以最上纵隔组[8／14（57.1 %）]、气管旁组[4／14（28.6 %）]最多；胸中段以气管旁组[21／41（51.2 %）]、主肺动脉窗组[17／41（41.5 %）]、隆突下组[15／41（36.6 %）]为最多；胸下段以贲门旁[7／19（36.8 %）]、胃左动脉旁[5／19（26.3 %）]为最多。结论　螺旋CT检查可以较准确地评估食管癌转移淋巴结的分布情况。

Diagnosis value of spiral CT for lymph node metastasis in thoracic esophageal carcinoma

Objective To analysis the spiral CT scan diagnosis value of lymph node metastasis in thoracic esophageal carcinoma and investigate the rules of lymph node metastasis distributions. Methods 117 patients with surgically and pathologically proved esophageal carcinoma underwent CT scans of the chest before the surgical operation to identify the presence of lymph node metastasis and evaluate the diagnosis value of spiral CT in lymph node metastasis. CT imaging which was detected by CT and histopathological analysis performed with attention to the distribution characteristics. Results In 117 cases of esophageal patients, the diagnosis of sensitivity, specific and accuracy degree on lymph node metastasis were 86.0 %,80.6 %, 84.6 %. The most lymph node metastasis in the upper thoracic esophagus is the mediastinum group[8/14 （57.1%）] and the trachea group [4/14（28.6 %）]. the middle is on the trachea surrounding group [21/41 （51.2 %）], the main pulmonary artery window group [17/41（41.5 %）] and subcarinal group[15/41（36.6 %）]. the lower thoracic esophagus is around the side of preventriculus [7/19（36.8 %）] and the left gastric artery [5/19 （26.3 %）]respectively. Conclusion Spiral CT imaging can accurately evaluate the lymph node metastasis of esophageal and distribution characteristics.