多层螺旋CT检查诊断食管癌T、N分期及对调强放疗后临床效果评估价值分析

目的分析多层螺旋CT检查诊断食管癌T、N分期及对调强放疗后临床效果评估价值。方法回顾性分析本院2016年6月至2019年4月收治的90例食管癌患者临床资料。根据食管癌的TNM分期标准6]结合MSCT检查所得结果进行诊断分析;以病理检查为金标准,评估MSCT检查对食管癌术前T、N分期的诊断准确率。结果以病理诊断为金标准,MSCT对食管癌术前T分期诊断准确率为66.67%(60/90),对N分期的诊断准确率为83.33%(75/90)。MSCT扫描图像可见管壁呈环状或不规则增厚,可形成肿块突向腔内或腔外,管腔变小而不规则,或偏向一侧。食管胸上段见软组织肿块,上自杓会厌破裂,下至主动脉弓水平,肿块边缘清晰,密度均匀,增强扫描轻到中度不均匀强化,食管腔狭窄,气管、甲状腺、邻近血管受压移位,纵膈可见肿大淋巴结。结论MSCT检查可清楚显示食管癌肿瘤的影像学特点,并对肿瘤分期作出准确判断,为临床医师提供重要的参考,值得广泛应用。

Value of Multi-Slice Spiral CT in the Diagnosis of T and N Staging of Esophageal Cancer and in the Evaluating Clinical Effect after Intensity-Modulated Radiotherapy

Objective To analyze the value of multi-slice spiral CT in the diagnosis of T and N staging of esophageal cancer and in the evaluating clinical effect after intensitymodulated radiotherapy.Methods The clinical data of 90 patients with esophageal cancer admitted to our hospital from June 2018 to April 2019 were retrospectively analyzed.According to the TNM staging criteria of esophageal cancer6]combined with the results of MSCT examination,diagnostic analysis was performed.Pathological examination was used as the gold standard to evaluate the diagnostic accuracy of MSCT in the preoperative T and N staging of esophageal cancer.Results With pathological diagnosis as the gold standard,the diagnostic accuracy of MSCT for preoperative T staging of esophageal cancer was 66.67%(60/90),and the diagnostic accuracy for N staging was 83.33%(75/90).The MSCT image showed that the wall of the tube was annular or irregularly thickened,which can form mass protruding into the cavity or outside the cavity,and the lumen became small and irregular,or was amesiality.In the upper thoracic part of esophagus,soft tissue mass was seen,up to the epiglottis rupture,down to the level of aortic arch.The edge of the mass was clear and the density was uniform.The enhanced scan lightly to moderately showed uneven enhancement,esophageal stenosis,translocation of tracheal,right thyroid,adjacent blood vessels under pressure.And enlarged lymph nodes was seen in mediastinum.Conclusion MSCT examination can clearly show the imaging features of tumors of esophageal cancer,and make accurate judgments on tumor staging,which provides an important reference for clinicians.It is worthy of wide application.