食管三维内镜超声检查：初步经验

Hünerbein M, Gretschel S, Ghadimi B M, Schlag P M

Röbert Rössle Hospital and Tumor Institute, Virchow University Hospital, Humboldt University, Berlin, Germany.

Surg Endosc. 1997 Oct;11(10):991-4. doi: 10.1007/s004649900509.

BACKGROUND

The aim of this study was to develop a technique for three-dimensional endoscopic ultrasound of the esophagus based on standard ultrasonic images.

METHODS

Endoscopic ultrasound was performed in five esophageal cancer patients using a high-resolution miniprobe (360 degrees, 12.5 MHz). For acquisition of three-dimensional data sets, the miniprobe was attached to a stepping motor that enabled ECG-triggered withdrawal of the transducer. Three-dimensional images were reconstructed from serial transverse sections on a PC-based 3D work station.

RESULTS

Twelve volume scans were obtained in five patients with esophageal cancer. The system enabled the acquisition of accurate three-dimensional ultrasound data within 30-50 s. Computed image processing allowed us to display the data in transverse, longitudinal, and oblique sections, or as a 3D reconstruction. Three-dimensional imaging provided accurate visualization of the tumor and surrounding structures in all cases. The tumor stage was determined correctly in four of five patients. Longitudinal scan planes and 3D views improved the assessment of longitudinal tumor infiltration and the spatial relation of the tumor to relevant mediastinal structures.

CONCLUSION

This study shows that three-dimensional endoscopic ultrasound of the esophagus is technically feasible. The technique allows the assessment of local tumor spread in previously unattainable scan planes and 3D views. This promising preliminary experience should encourage further exploration of this method.

背景

本研究的目的是基于标准超声图像开发一种食管三维内镜超声技术。

方法

使用高分辨率微型探头（360度，12.5兆赫）对5例食管癌患者进行内镜超声检查。为获取三维数据集，将微型探头连接到一个步进电机上，该电机可实现由心电图触发的换能器回撤。在基于个人计算机的三维工作站上从连续横断面上重建三维图像。

结果

5例食管癌患者共获得12次容积扫描。该系统能够在30至50秒内获取准确的三维超声数据。计算机图像处理使我们能够在横断面、纵断面和斜断面显示数据，或进行三维重建。三维成像在所有病例中都能准确显示肿瘤及周围结构。5例患者中有4例肿瘤分期判断正确。纵断面扫描平面和三维视图改善了对肿瘤纵向浸润以及肿瘤与相关纵隔结构空间关系的评估。