Ringe Kristina I, Meyer Simone, Ringe Bastian P, Winkler Michael, Wacker Frank, Raatschen Hans-Juergen
Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany.
Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany.
Eur J Radiol. 2015 Feb;84(2):215-20. doi: 10.1016/j.ejrad.2014.11.008. Epub 2014 Nov 18.
To assess the value of oral effervescent powder (EP) for evaluation of esophageal distension, and for detection and staging of esophageal cancer with contrast-enhanced CT.
84 patients without esophageal pathology and 52 patients with histological confirmed diagnosis of esophageal cancer were included in this prospective IRB-approved study. Half of the patients in both groups received EP prior to CT. Esophageal distension was assessed by planimetry of the inner (IA) and outer area (OA). Two blinded readers evaluated the datasets separately with regard to diagnosis of esophageal cancer (yes/no) and staging (T0-T4), if applicable. Distension results were compared (t-Test). In patients with cancer sensitivity, specificity, NPV and PPV were calculated. CT staging results were compared to histopathology (Cohen-k).
IA and IA/OA were significantly larger after EP as compared to the group without EP (p<0.05). Sensitivity, specificity, NPV and PPV for cancer detection cancer were as follows: 78%/78%, 98%/98%, 95%/95%, 87%/87% with EP; 60%/68%, 98%/98%, 94%/94%, 80%/83% without EP. Staging with EP was good (k=0.84/0.67) and moderate without EP (k=0.58/0.59).
Administration of EP prior to CT results in good distension of the esophagus, and improves detection and staging of esophageal cancer, as compared to control studies without EP.
评估口服泡腾粉剂（EP）在食管扩张评估以及通过增强CT检测和分期食管癌方面的价值。
本前瞻性研究经机构审查委员会（IRB）批准，纳入了84例无食管病变的患者和52例经组织学确诊为食管癌的患者。两组患者各有一半在CT检查前服用EP。通过测量食管内面积（IA）和外面积（OA）进行食管扩张评估。两名盲法阅片者分别对数据集进行评估，判断是否存在食管癌（是/否）以及适用时进行分期（T0 - T4）。比较两组的扩张结果（t检验）。计算癌症患者的敏感度、特异度、阴性预测值和阳性预测值。将CT分期结果与组织病理学结果进行比较（Cohen-k检验）。
与未服用EP的组相比，服用EP后IA和IA/OA显著增大（p<0.05）。服用EP时癌症检测的敏感度、特异度、阴性预测值和阳性预测值分别为：78%/78%，98%/98%，95%/95%，87%/87%；未服用EP时分别为：60%/68%，98%/98%，94%/94%，80%/83%。服用EP时的分期效果良好（k = 0.84/0.67），未服用EP时为中等（k = 0.58/0.59）。
与未服用EP的对照研究相比，CT检查前服用EP可使食管良好扩张，改善食管癌的检测和分期。
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