【摘要】 目的 评价多层螺旋CT(multi-slice computed tomography,MSCT)对胸段食管鳞癌各区域淋巴结转移的诊断效能并探讨其淋巴结转移的分布特征。方法 回顾性分析190例行根治性切除术的胸段食管鳞癌患者的CT资料,观察MSCT所示颈部,上、中、下纵隔区及腹部淋巴结的大小及数目,判断其转移情况,并与术后病理进行对照。结果 全组淋巴结转移率为44.7%,淋巴结转移度为10.7%。胸上、中、下段食管鳞癌淋巴结转移率分别为55.6%(15/27)、67.6%(73/108)和78.2%(43/55)。胸上、中、下段食管癌淋巴结转移率最高者分别为105组(14.8%)、108组(23.1%)、110组(36.4%)。术前MSCT诊断中纵隔淋巴结转移的敏感性、特异性、阳性预测值、阴性预测值、Youden指数分别为69.4%、85.8%、35.6%、96.1%、0.552。结论 胸段食管鳞癌最常见的转移部位为肿瘤相应部位食管旁淋巴结,术前MSCT增强扫描能准确地反映食管癌淋巴结转移的分布规律并能提高诊断率。更多还原

【Abstract】 Objective To evaluate the diagnostic performance of multi-slice computed tomography for lymph node metastasis in patients with thoracic esophageal carcinoma and to explore the distribution characteristics of lymph node metastases in patient with thoracic esophageal carcinoma.Methods Contrast-enhanced MSCT images of 190 consecutive patients with thoracic esophageal carcinoma were retrospectively reviewed.All patients underwent radical resection.The lymph nodes’ size and number in every regions were evaluated,after postoperative pathology and CT results were reviewed and compared.Results The overall rate of lymph node metastasis was 44.7%,the degree of lymph node metastasis was 10.7%.The rates of lymph nodes metastasis for upper,middle,and lower thoracic esophageal carcinoma were 55.6%(15/27),67.6%(73/108)and 78.2%(43/55)respectively,the most commonly metastasized region was NO.105(14.8%),NO.108(23.1%) and NO.110(36.4%).For middle mediastinal region the sensitivity,specificity,positive predictive values,negative predictive values,and Youden’ s index of preoperative MSCT scan were 69.4%,85.8%,35.6%,96.1% and 0.552.Conclusion The most common region of lymph node metastasis for thoracic esophageal carcinoma is the region around the esophageal.Preoperative contrast-enhanced MSCT scan can accurately reveal the distribution of lymph node metastasis of thoracic esophageal carcinoma and improve diagnostic accuracy.更多还原