胸段食管癌颈胸腹三野淋巴结转移的CT表现与分布特征

目的通过对胸段食管癌颈胸腹三野淋巴结转移CT影像分析,探讨其分布特征。方法对110例经病理及影像随诊证实胸段食管癌转移性淋巴结的位置、大小、数目、形态及强化特征进行分析。淋巴结根据美国胸科协会（ATS）的纵隔淋巴结分组标准及颈腹部淋巴结分组标准分为15组,设定淋巴结直径大于1.0 cm为转移淋巴结。结果 110例胸段食管癌中,共观察到231枚转移性淋巴结。胸段食管癌淋巴结转移以右下气管旁组、主肺动脉窗组、隆突下组最多,其次为右上气管旁组、右锁骨上组、胃左动脉旁组及腹腔干旁组。中上段食管癌注意观察右上气管旁组及右锁骨上组,中下段食管癌注意观察胃左动脉旁组及腹腔干旁组。结论螺旋CT可以准确显示颈胸腹三野淋巴结转移的分布特征,为临床分期及选择合理化的治疗方案提供重要依据。

CT findings and distribution features of lymph node metastasis of neck-mediastinum-abdomen in patients with thoracic esophageal carcinoma

Objective To analyze the CT findings of metastatic lymph nodes in neck-mediastinum-abdomen from esophageal carcinoma so as to understand their distribution features.Methods The location,size,number,shape and enhanced pattern of the metastatic lymph nodes in 110 patients with thoracic esophageal corcinoma proved pathologically and clinically were retrospectively analyzed.According to grouping standards of the ATS＇S mediastinal and neck-abdomen lymph nodes,the lymph nodes were classified into 15 groups.Setting the standard of the metastatic lymph node was 1.0 cm for short diameter greater.Results Total 231 metastatic lymph nodes were found in 110 cases with thoracic esophageal carcinoma.The metastatic lymph nodes of thoracic esophageal carcinoma were mainly the right inferior paratracheal nodes,the aortopulmonary window nodes and the subcarinal nodes,following by the right superior paratracheal nodes,the right supraclavicular nodes,the left gastric artery nodes and the coeliac artery nodes.The right superior paratracheal nodes and right supraclavicular nodes were closely observed for middle-upper segment esophageal carcinoma.The lymph nodes around left gastric artery and coeliac artery were closely observed for middle-lower segment esophageal carcinoma.Conclusion Spiral CT imaging can accurately visualize the distribution features of metastatic lymph nodes in neck-mediastinum-abdomen so that it can provide the important evidence for clinical classifying and selecting therapeutic protocol.