食管癌的影像学表现

Diagnostic imaging is carried out in patients with esophageal carcinoma in order to decide on the therapeutical procedure, to control therapy, to document complications and to assess concomitant diseases.Chest X-rays and esophagograms give a 2-dimensional view of the X-ray absorption ill 3-dimensional examination volumes, the diagnostic accuracy thus being limited by overshadowing. Because of the robust examination technique, the broad availability and the low costs chest X-rays are usually used for short-term controls under therapy and follow-up. Esophagography is carried out in order to asses the exact location and length of a known esophageal carcinoma prior to therapy and in order to assess peristaltic disturbances and fistulas. CT and MRI provide tomographic images with a spatial resolution of up to 1mm^3 allowing the reconstruction of high-resolution images not only in the transversal but also in any other plain. The diagnostic accuracy of esophagography is comparatively high in T1 T3 stages (80%-90%). T1 and T2 tumors cannot be diagnosed by CT and MRI, because both methods do not visualize the mucosa(unlike esophagography and endoscopy) and the esophageal wall layers (unlike EUS). Infiltration depth tends to be overestimated in T1 and T2 carcinomas and to be underestimated in T3 and T4 cancers. CT and MRI cannot detect metastases in normally sized lymph nodes and cannot accurately differelltiate between benign and malignant lymphadenopathy in enlarged nodes with a reported sensitivities and spccifities of 60% and 74%, respectively. However, further prospective studies using up to date CT and NIR technology are needed to assess the present diagnostic situation. CT and MRI do not only visualize the inediastinum,but also the lungs, the pleura and the skeleton as well as the neck and the abdomen thus providing a comprehensive overview of the TNM stage in 3 body regions.

Radiological Imaging in Patients with Esophageal Carcinoma

Diagnostic imaging is carried out inpatients with esophageal carcinoma in order to decide on thetherapeutical procedure, to control therapy, to documentcomplications and to assess concomitant diseases. Chest X-rays andesophagograms give a 2-dimensional view of the X-ray absorption in3-dimensional examination volumes, the diagnostic accuracy thusbeing limited by overshadowing. Because of the robust examinationtechnique, the broad availability and the low costs chest X-raysare usually used for short-term controls under therapy andfollow-up. Esophagography is carried out in order to asses theexact location and length of a known esophageal carcinoma prior totherapy and in order to assess peristaltic disturbances andfistulas. CT and MRI provide tomographic images with a spatialresolution of up to 1 mm³ allowing the reconstruction ofhigh-resolution images not only in the transversal but also in anyother plain. The diagnostic accuracy of esophagography iscomparatively high in T1--T3 stages (80%--90%). T1 and T2tumors cannot be diagnosed by CT and MRI, because both methods donot visualize the mucosa (unlike esophagography and endoscopy) andthe esophageal wall layers (unlike EUS). Infiltration depth tendsto be overestimated in T1 and T2 carcinomas and to beunderestimated in T3 and T4 cancers. CT and MRI cannot detectmetastases in normally sized lymph nodes and cannot accuratelydifferentiate between benign and malignant lymphadenopathy inenlarged nodes with a reported sensitivities and specifities of60% and 74%, respectively. However, further prospectivestudies using up to date CT and MR technology are needed to assessthe present diagnostic situation. CT and MRI do not only visualizethe mediastinum, but also the lungs, the pleura and the skeletonas well as the neck and the abdomen thus providing a comprehensiveoverview of the TNM stage in 3 body regions.