CT扫描及超声内镜术前评价进展期食管癌

目的比较胸部螺旋CT增强扫描及微探头超声内镜 (MPS)检查在评价进展期食管癌中的价值。方法 :32例进展期食管癌术前行CT扫描和MPS检查并与术后病理学比较。结果 :CT扫描能发现 84 .4 %的食管癌病灶 ,但不能准确诊断癌肿浸润深度 ,诊断纵隔结构受侵准确率 75 % ,发现区域淋巴结转移的敏感性90 .9% ,特异性 81.8% ,对纵隔内远处淋巴结转移诊断准确率 80 %。MPS检查能检出所有病例的进展期食管癌病灶 ,癌肿浸润深度诊断准确率 81.3% ,诊断纵隔结构受侵准确率 5 0 % ,诊断区域淋巴结转移敏感性81.8% ,特异性 72 .7% ,而对纵隔内远处转移的淋巴结均未能探及。结论 :CT扫描在评价进展期食管癌纵隔内结构受侵及远处淋巴结转移的意义较大。而MPS检查在判断癌肿管腔浸润深度的准确率较高。

PREOPERATION EVALUATION ON ADVANCED ESOPHAGEAL NEOPLASMS IN CT AND MINIATURE PROBE SCANNER

Objective:To compare the value of enhancement CT with Miniature Probe Scanner (MPS) in diagnosing advanced esophageal neoplasms. Method:We reviewed the preoperation CT and MPS appearance of 32 cases of advanced esophageal neoplasms proved by pathology.Results: 84.8% foci of esophageal neoplasms were depicted by CT scanning which could not accurately diagnose how deep the carcinoma infiltrated.Accuracy of invasion of mediastinum was 75%.Sensitivity and sepcificity of CT scanning for region nodal metastases were 90.9% and 81.8%,whereas the accuracy of distant nodal metastases was 80%.All of 32 cases of advanced esophageal neoplasms were identified at MPS examination.Accuracy of carcinoma infiltrative depth was 81.3%.Accuracy of invasion of mediastinum was 50%.Sensititity and specificity of region nodal metastases were 81.8% and 72.7%,but distant nodal metastases in mediastinum could not be found.Conclusions:Enhancement CT scanning is more significant in evaluating invasion in mediastinum and distant nodal metastases,whereas the accuracy rate of diagnosing carcinoma infiltrative depth with MPS examination is greater.