食管结核的影像学诊断(附5例报告)

目的　探讨食管结核的影像学表现 ,提高对该病的认识。方法　回顾性分析 5例经病理证实的食管结核 ,男 2例 ,女 3例 ,年龄 2 4～ 3 6岁 ,平均 2 9岁。 5例均行食管钡剂造影、CT和电子纤维胃镜检查 ,1例行手术治疗。结果　食管钡剂造影示 :食管上段 1例 ,中段 3例 ,下段 1例 ,表现为充盈缺损 2例 ,向心性狭窄 2例 ,腔内点状钡斑 1例 ,腔外不规则窦道形成 1例。黏膜纹破坏2例 ,平坦或消失 3例。胸部CT平扫 :1例左肺下叶后基底段支气管扩张 ,右肺门增大 ,右胸壁有小结节 ;1例食管下段管壁不规则增厚 ;1例胸膜肥厚粘连 ;2例未见明显异常。术前影像学误诊 3例 ,正确诊断 2例。结论　食管结核缺乏影像学的特点 ,诊断应密切结合临床。

The Imaging Diagnosis of Esophageal Tuberculosis(A Report of 5 cases)

Objective To investigate the imaging appearances of esophageal tuberculosis.Methods 5 cases of esophageal tuberculosis proved by pathology were retrospectively analyzed.There were 2 male and 3 female patients aged between 24 and 36 years median age 29 years. All cases were undergone esophageal barium examination, CT scan and gastroscopy. The surgical resection of the tumor was complemented in one case.Results Esophageal barium contrast study showed: the location of lesions at upper, middle and low esophagus in 1,3 and 1 cases respectively. The X-ray features included filling defect in 2 cases, centripetal strictures in 2 cases, intraluminal barium patch in 1 case, extramural irregular fistulous formation in 1 case, mucosa destruction in 2 cases and mucosa flattened or disappeared in 3 cases. On chest CT, bronchiectasis in the posterior basal segment of left inferior lung in 1 case, enlargement of right hilum of lung and small nodule in the right chest wall in 1 case, irregular thickening in the wall of inferior oesophagus in 1 case, pleural adhesion in 1 case were showed, and the other two were normal. The accurate diagnosis was confirmed only in 2 patients preoperation.Conclusion Esophageal tuberculosis extent is not of imaging characteristics, its diagnosis should be in combination with clinical data.