Purpose To explore multi-slice spiral CT (MSCT) in differential diagnosis of esophageal leiomyoma and esophageal carcinoma.Material and Methods Plain chest CT scan and enhanced inspection image of 26 patients with esophageal leiomyoma and 68 patients with esophageal carcinoma at the same term which had been confirmed by surgery and pathology were retrospectively analyzed.Characteristics such as focus size,morphology,density and tumor-air surface,etc were recorded and compared.Results MSCT of esophageal leiomyoma showed uniform density,possible calcification,polylimited influence of esophageal wall,scarcity of depression in focus niche,smooth tumor-air surface,low degree of enhanced amplification,and cerioid expansion of related lumen of larger focus.However,MSCT in esophageal carcinoma was represented by thickened annulus of esophageal wall,no calcification of focus,familiarity of depression in focus niche,rough tumor-air surface and intermediate degree strengthening.Differences of contrast of calcification,polylimited influence of esophageal wall,scarcity of depression in focus niche,smooth tumor-air surface in sophageal leiomyoma with that of esophageal carcinoma were statistically significant (P＜0.05).Conclusion MSCT can accurately identify sophageal leiomyoma and esophageal carcinoma,offering evidence for clinical diagnosis and treatment.%目的 探讨多层螺旋CT (MSCT)在食管平滑肌瘤与食管癌鉴别诊断中的价值.资料与方法 回顾性分析经手术及病理证实的26例食管平滑肌瘤患者及同期68例食管癌患者的胸部CT平扫及增强扫描图像,记录并比较两者的病灶大小、形态、密度、瘤-空气界面等特征.结果 食管平滑肌瘤的MSCT表现为密度均匀、可有钙化、食管壁多局限受累、病灶龛影样凹陷少见、瘤-空气界面光滑、强化幅度低、较大病灶相应管腔多角状扩张等特征;而食管癌则多表现为管壁环周增厚、病灶无钙化、病灶龛影样凹陷常见、瘤-空气界面多不光滑、中等程度强化等特点.食管平滑肌瘤在钙化、食管壁多局限受累、病灶龛影样凹陷少见、瘤-空气界面光滑等征象方面与食管癌比较,差异有统计学意义(P＜0.01).结论 MSCT能够较准确地鉴别食管平滑肌瘤和食管癌,为临床诊断与治疗提供依据.
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