Noh Seung Yeon, Kim Hyun Jin, Lee Hyun Joo, Park Seong Ho, Lee Jong Seok, Kim Ah Young, Ha Hyun Kwon
1 All authors: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic Ro, 43-Gil, Songpa-gu, Seoul, 05505, Korea.
AJR Am J Roentgenol. 2017 Jun;208(6):1237-1243. doi: 10.2214/AJR.16.17138. Epub 2017 Mar 23.
The purpose of this study was to evaluate the esophagographic and CT findings of corrosive esophageal cancer.
The records of all patients who presented with corrosive esophageal strictures at one institution between June 1989 and April 2015 were retrospectively identified. The search yielded the records of 15 patients with histopathologically proven esophageal cancer. Esophagograms (13 patients) and chest CT images (14 patients) were interpreted independently by two reviewers. Esophagographic findings included the location of tumor, morphologic type, presence and length of mucosal irregularity, presence of asymmetric involvement, and presence of rigidity. CT findings included presence and type of esophageal wall thickening, pattern of enhancement, presence of periesophageal infiltration, and presence of hilar or mediastinal lymphadenopathy.
Esophagography showed that the tumor was involved with the stenotic portion in 10 of the 13 patients (76.9%). The most common morphologic feature was a polypoid mass, in 10 patients. In 12 patients (92.3%), mucosal irregularities were observed; the mean affected length was 4.92 cm. Asymmetric involvement and rigidity were observed in nine patients (69.2%). On CT scans, eccentric wall thickening was observed in 10 of the 14 patients (71.4%), homogeneous enhancement in nine (64.2%), and periesophageal infiltration in 11 (78.5%).
Esophagography commonly shows corrosive esophageal cancer as a polypoid mass with long-segment mucosal irregularities at the stenotic portion, asymmetric involvement, and rigidity. CT shows eccentric esophageal wall thickening with homogeneous enhancement and periesophageal infiltration, which are suggestive of the development of malignancy in patients with corrosive esophageal strictures.
本研究旨在评估腐蚀性食管癌的食管造影和CT表现。
回顾性分析1989年6月至2015年4月期间在某一机构出现腐蚀性食管狭窄的所有患者的记录。检索出15例经组织病理学证实为食管癌的患者记录。食管造影(13例患者)和胸部CT图像(14例患者)由两名阅片者独立解读。食管造影表现包括肿瘤位置、形态类型、黏膜不规则的存在及长度、不对称受累情况以及僵硬程度。CT表现包括食管壁增厚的存在及类型、强化方式、食管周围浸润情况以及肺门或纵隔淋巴结肿大情况。
食管造影显示,13例患者中有10例(76.9%)肿瘤累及狭窄部位。最常见的形态学特征是息肉样肿物,见于10例患者。12例患者(92.3%)观察到黏膜不规则;平均受累长度为4.92 cm。9例患者(69.2%)观察到不对称受累和僵硬。在CT扫描中,14例患者中有10例(71.4%)观察到偏心性壁增厚,9例(64.2%)为均匀强化,11例(78.5%)有食管周围浸润。
食管造影通常显示腐蚀性食管癌为息肉样肿物,在狭窄部位有长段黏膜不规则、不对称受累和僵硬。CT显示偏心性食管壁增厚伴均匀强化和食管周围浸润,提示腐蚀性食管狭窄患者发生了恶性病变。