Ba-Ssalamah Ahmed, Zacherl Johannes, Noebauer-Huhmann Iris Melanie, Uffmann Martin, Matzek Wolfgang Karl, Pinker Katja, Herold Christian, Schima Wolfgang
Department of Radiology, Medical University of Vienna, Waehringer Guertel, Vienna, Austria.
Abdom Imaging. 2009 Jan-Feb;34(1):3-18. doi: 10.1007/s00261-007-9290-5.
Multi-detector computed tomography (CT) offers new opportunities in the imaging of the gastrointestinal tract. Its ability to cover a large volume in a very short scan time, and in a single breath hold with thin collimation and isotropic voxels, allows the imaging of the entire esophagus with high-quality multiplanar reformation and 3D reconstruction. Proper distention of the esophagus and stomach (by oral administration of effervescent granules and water) and optimally timed administration of intravenous contrast material are required to detect and characterize disease. In contrast to endoscopy and double-contrast studies of the upper GI tract, CT provides information about both the esophageal wall and the extramural extent of disease. Preoperative staging of esophageal carcinoma appears to be the main indication for MDCT. In addition, MDCT allows detection of other esophageal malignancies, such as lymphoma and benign esophageal tumors, such as leiomyma. A diagnosis of rupture or fistula of the esophagus can be firmly established using MDCT. Furthermore, miscellaneous esophageal conditions, such as achalasia, esophagitis, diverticula, and varices, are incidental findings and can also be visualized with hydro-multi-detector CT. Multi-detector CT is a valuable tool for the evaluation of esophageal wall disease and serves as an adjunct to endoscopy.
多排螺旋计算机断层扫描（CT）为胃肠道成像带来了新机遇。它能够在极短的扫描时间内覆盖大容积区域，且在一次屏气时以薄层准直和各向同性体素进行扫描，从而可通过高质量的多平面重建和三维重建对整个食管进行成像。为了检测和鉴别疾病，需要使食管和胃适度扩张（通过口服泡腾颗粒和水）并优化静脉造影剂的给药时机。与上消化道内镜检查和双重对比造影研究不同，CT能提供有关食管壁及疾病壁外范围的信息。食管癌的术前分期似乎是多排螺旋CT的主要适应证。此外，多排螺旋CT还能检测其他食管恶性肿瘤，如淋巴瘤，以及食管良性肿瘤，如平滑肌瘤。使用多排螺旋CT可明确诊断食管破裂或瘘管。此外，诸如贲门失弛缓症、食管炎、憩室和静脉曲张等各种食管疾病，虽为偶然发现，但也可通过水充盈多排螺旋CT显示出来。多排螺旋CT是评估食管壁疾病的重要工具，可作为内镜检查的辅助手段。
