Schüder G, Kreissler-Haag D, Seitz G, Feifel G
Allgemeine, Abdominal- und Gefässchirurgie, Universitätskliniken des Saarlandes, Homburg/Saar.
Bildgebung. 1995 Oct;62 Suppl 2:29-34.
It was only the endoscopic ultrasonography that allowed the esophagus and posterior mediastinum to be accessible to ultrasonography. The esophageal wall may be presented in its different anatomic layers to a degree of precision unattained by any other imaging procedure. Being important in the esophagus, both the upper rim of the tumor and the infiltration depth can this way be prognosed correctly to about 85%. In consequence, this allows proceedings appropriate to the tumor stage within the bounds of a multimodal therapeutic concept of esophagus carcinomas. Impressions of the esophagus caused by mediastinal tumors are safely distinguished from intramural tumors. Multiple biopsies to get an examination specimen from a deeper layer should be performed under no other conditions than after endoscopic ultrasonographic examination and just for special questions. In the differential diagnosis of achalasia and peptic stenosis of the esophagus, endoscopic ultrasonography proved to be less efficient. As for bronchial carcinomas, conclusive hints may be drawn from transesophageal and intratracheal ultrasonography. However, due to limited possibilities of judgment caused by air-containing structures these methods are not firmly established in the preoperative staging.
只有内镜超声检查才能使食管和后纵隔接受超声检查。食管壁的不同解剖层次得以呈现，其精确程度是其他任何成像检查都无法达到的。对于食管来说很重要的一点是，通过这种方式，肿瘤上缘和浸润深度的预后判断正确率可达约85%。因此，在食管癌多模式治疗理念范围内，这使得能够采取适合肿瘤分期的治疗措施。纵隔肿瘤所致食管压迹能与壁内肿瘤可靠地区分开来。只有在内镜超声检查之后，且仅针对特殊问题，才应在其他条件下进行多次活检以获取深层检查标本。在内镜超声检查中，食管失弛缓症和消化性狭窄的鉴别诊断效果欠佳。对于支气管癌，经食管和气管内超声检查可能会得出决定性线索。然而，由于含气结构导致判断可能性有限，这些方法在术前分期中尚未得到稳固确立。
