食管肿瘤:肺计算机断层扫描诊断的关键

F. Conca , N. Rosso , R. López Grove , L. Savluk , J.P. Santino , M. Ulla
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摘要

目的回顾和描述最常见的食道肿瘤病变的最特征性影像学表现,重点介绍食道胃扩张技术肺计算机断层扫描。了解这种扩张技术的主要优点。结论恶性肿瘤病变(以食管中段鳞状细胞癌和食管远端腺癌为主)表现为食管壁不对称增厚、粘膜不规则或肿块向邻近脏器扩散并累及淋巴结。良性肿瘤(主要是平滑肌瘤最常见,其他如脂肪瘤)表现为腔内生长,边界明确,均匀衰减。对比后增强很少或中度。在所有病例中,计算机断层扫描技术可实现食管腔的额外扩张。它可以划定病变的上下边界,帮助外科医生确定治疗策略。
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Esophageal tumors: The keys to diagnosis by pneumo-computed tomography

Objective

To review and describe the most characteristic radiological findings of the most frequent esophageal tumor lesions, with emphasis on the esophago-gastric distention technique pneumo-computed tomography performed in our institution. To know the main advantage of this distension technique.

Conclusion

Malignant tumor lesions (predominantly squamous cell carcinoma in the mid esophagus and adenocarcinoma in the distal esophagus) present as asymmetric wall thickening, mucosal irregularity, or mass extending into adjacent organs with lymph node involvement. Benign tumors (mainly leiomyoma being the most frequent and others such as lipoma) present as endoluminal growth, with defined borders and homogeneous attenuation. Post-contrast enhancement is scarce or moderate. The technique of computed tomography pneumotomography technique achieves an additional distension of the esophageal lumen in all cases. It allows delimiting the superior and inferior borders of the lesions, helping the surgeon to define the therapeutic strategy.

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