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食管憩室并食管及贲门癌的X线诊断价值

Value of X-ray Barium Meal Examination in the Diagnosis of Esophageal Diverticulum Associated with Esophagus or Gastric Cardiac Carcinoma
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摘要 目的:探讨X线钡餐造影对食管憩室并食管及贲门癌的诊断价值。方法:回顾性分析18例经X线钡餐检查、纤维内镜和手术病理证实的食管憩室并食管、贲门癌的X线表现。结果:18例中,单发憩室15例,多发憩室3例,其中最多1例有5个憩室。3个有液气平面。11例食管憩室位于肿瘤之上,7例憩室与肿瘤重叠。食管癌15例,贲门癌3例。憩室X线表现为囊袋状或尖角状钡影突出,肿瘤处黏膜不规则中断破坏、不规则充盈缺损及龛影形成,管腔狭窄,管壁僵硬,扩张度差,对比剂通过缓慢。结论:X线钡餐检查是诊断食管憩室并食管癌、贲门癌最简单、可靠、安全的方法,并能为内镜提供准确的定位,避免憩室穿孔危险。 Objective:To investigate the value of X-ray barium meal examination in the diagnosis of esophageal diverticulum (ED) associated with esophageal/gastro-cardiac carcinoma. Methods:X-ray features of 18 cases having esophageal diverticulum associated with esophagus or gastric-cardiac carcinoma proved by barium meal examination, fibro-endoscopy, surgery and pathology were analyzed retrospectively. Results: Of the 18 cases there were solitary diverticulum (15 cases), multiple diverticula (3 cases,1 case had totally 5 diverticula). The X-ray features showed air fluid level (3 cases). The diverticulum located superior to the carcinoma (11 cases), or the diverticulum overlapped with carcinoma (7 cases). There were 15 cases with esophageal cancer and 3 cases with gastric cardiac cancer. X-ray manifestations of diverticulum were saclike or pointed protrusion of barium shadow and that of carcinoma were irregular disruption and destruction of mucous membrane, irregular filling defect and niche formation, lumen stricture, inflexible and rigid esophageal wall, limited expansibility and blockage of barium stream. Conclusion:X-ray barium meal examination is the most easy, reliable and safe method for the diagnosis of esophageal diverticulum associated with carcinoma of esophagus or gastric cardia,which provides accurate localization for fibro-endoscopy,help to avoid the risk of diverticulum perforation.
出处 《放射学实践》 北大核心 2009年第10期1096-1098,共3页 Radiologic Practice
关键词 憩室 食管 食管肿瘤 贲门肿瘤 体层摄影术 X线计算机 Diverticulum,esophageal Esophageal neoplasms Gastric cardia neoplasms Tomography,X-ray computed
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