Ulla Marina, Cavadas Demetrio, Muñoz María Inés, Beskow Axel, Yeyati Ezequiel Levy, Wright Fernando, Seehaus Alberto, García-Mónaco Ricardo
Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires.
Acta Gastroenterol Latinoam. 2010 Mar;40(1):46-53.
Pre-surgical characterization and staging of esophageal and esophagogastric union cancer with only one imaging method could be useful for the therapeutic strategy.
Twenty-four patients with endoscopic diagnosis of esophageal and cardial cancer were prospectively studied with PnCT64 before surgery. CT's were performed with a 64 row CT scanner and in order to achieve esophageal distension, CO2 was instilled with an automated insufflator through a Foley catheter. Mural thickening was evaluated as well as its scope, shape and anatomic location by using different type of reconstructions. PnCT64 findings were correlated with anatomopathological staging.
In 21 patients an asymmetric wall thickening was observed with a sensitivity of 86.4% in correlation with anatomopathological findings. Adequate gastroesophageal distension defining the limits of the lesions was achieved in all patients.
PnCT64 showed high sensitivity in the diagnosis of esophageal and cardial thickening. Gastric distension proved to be useful for the presurgical evaluation defining both upper and lower borders of the tumors located in the gastroesophageal junction.
仅用一种成像方法对食管及食管胃结合部癌进行术前特征描述和分期，可能有助于制定治疗策略。
1）评估气钡双对比64层螺旋CT（PnCT64）诊断食管-贲门壁增厚的敏感性，并与解剖病理学及术后结果进行对比。2）评估胃扩张在食管癌术前规划中的作用，尤其是位于胃食管交界处的肿瘤。
对24例经内镜诊断为食管癌和贲门癌的患者在术前进行前瞻性PnCT64研究。使用64排CT扫描仪进行CT检查，为使食管扩张，通过Foley导管用自动注气装置注入二氧化碳。利用不同类型的重建方法评估壁增厚情况及其范围、形态和解剖位置。将PnCT64的结果与解剖病理学分期进行对比。
21例患者观察到不对称壁增厚，与解剖病理学结果对比的敏感性为86.4%。所有患者均实现了对病变界限的充分胃食管扩张。
PnCT64在诊断食管和贲门增厚方面显示出高敏感性。胃扩张被证明对术前评估确定位于胃食管交界处肿瘤的上下边界有用。
