Wang Jiafu, Tang Liang, Lin Lin, Li Yanyan, Li Jin, Ma Wenbo
Department of Nuclear Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of CT, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
J Gastrointest Oncol. 2022 Feb;13(1):49-55. doi: 10.21037/jgo-22-36.
To explore the imaging characteristics of esophageal cancer in multi-slice spiral CT (MSCT) and barium meal radiography and to analyze the value of the two examinations alone or in combination for cancer staging diagnosis.
The clinical data of 87 patients with esophageal cancer admitted to our hospital from June 2018 to June 2020 were retrospectively analyzed. According to the different examination methods, they were divided into a barium meal group (n=28 cases, X-ray barium meal radiography), an MSCT group (n=29 cases, MSCT examination), and a combined group (n=30 cases, barium meal + MSCT). The imaging characteristics from the barium meal radiography and MSCT alone versus their combined results were compared with the pathological examination results to analyze their accuracy in diagnosing esophageal cancer staging.
Of the 87 cases, the esophageal cancer lesion sites were as follows: 23 cervical cases, 20 upper thoracic cases, 21 middle thoracic cases, and 23 lower thoracic cases. The X-ray barium meal examination of esophageal mucosa showed irregular filling of the esophagus. The esophageal wall was stiff or jagged, the lumen was narrow, and it was difficult for the barium to pass, the mucosa was discontinuous. The CT scan showed irregular thickening of the esophageal wall, eccentric and concentric stenosis of the esophageal cavity, and the upper part of the esophagus showed different degrees of expansion. The trachea and bronchi were invaded, deformed, and displaced under compression. The diagnostic staging results of the barium meal group and MSCT group were inconsistent with the pathological results (Kappa =0.105, 0.112; P>0.05). The diagnostic staging results of the combined group were in good agreement with the pathological results (Kappa =0.769). In addition, the accuracy of the combined group in the diagnosis of stage III-IV esophageal cancer among the three groups was significantly higher than that of the barium meal group and MSCT group alone (P<0.05).
MSCT and barium meal radiography clearly display the imaging features of esophageal cancer and can provide reliable imaging evidence for preoperative diagnosis; the combination of both measures can effectively improve the accuracy of early diagnosis for esophageal cancer.
探讨多层螺旋CT（MSCT）及钡餐造影检查对食管癌的影像学特征，并分析两种检查单独及联合应用对癌分期诊断的价值。
回顾性分析2018年6月至2020年6月我院收治的87例食管癌患者的临床资料。根据检查方法不同，分为钡餐组（n = 28例，X线钡餐造影）、MSCT组（n = 29例，MSCT检查）和联合组（n = 30例，钡餐 + MSCT）。将钡餐造影和MSCT单独的影像学特征及其联合结果与病理检查结果进行比较，分析其对食管癌分期诊断的准确性。
87例患者中，食管癌病变部位如下：颈段23例，胸上段20例，胸中段21例，胸下段23例。食管黏膜X线钡餐检查显示食管充盈不规则。食管壁僵硬或呈锯齿状，管腔狭窄，钡剂通过困难，黏膜连续性中断。CT扫描显示食管壁不规则增厚，食管腔偏心性及同心性狭窄，食管上段呈不同程度扩张。气管及支气管受侵、受压变形及移位。钡餐组和MSCT组的诊断分期结果与病理结果不一致（Kappa = 0.105，0.112；P > 0.05）。联合组的诊断分期结果与病理结果一致性良好（Kappa = 0.769）。此外，联合组对Ⅲ - Ⅳ期食管癌的诊断准确性在三组中显著高于单独的钡餐组和MSCT组（P < 0.05）。
MSCT及钡餐造影能清晰显示食管癌的影像学特征，可为术前诊断提供可靠的影像学依据；两者联合应用可有效提高食管癌早期诊断的准确性。
