低张双重造影数字成像对食管隆起性肿瘤的诊断价值

摘要

Objective:To explore the value of hypotonic double contrast examination (HDCE) of the esophagus in the characterization of esophageal neoplasm. Methods: A retrospective analysis of HDCE of the esophagus was performed in 102 patients with esophagus neoplasm. All the benign (n=28) and malignant (n=74) neoplasm were proved by gastroscopic bi opsies and surgical pathology. We specifically compared HDCE characteristics between benign and malignant neoplasms. Results:Among 102 cases with esophagus neoplasm,differentiation of benign and malignant lesions <1cm in maximum di ameter (n = 12) was the changes in esophageal contour and function on HDCE with accuracy of 75% ;differentiation of le sions 1-3cm (n=37) was the changes in esophageal contour and function,shape of the mass and barium coating on HDCE with accuracy of 94. 6% ;differentiation of lesions >3cm (n= 53) was the changes in the mucous membranes and barium coating on HDCE with accuracy of 95. 2%%. The total accuracy of HDCE was 93. 1%. The accuracy of HDCE increased with the increase in lesion size. Conclusions: HDCE plays key roles in the characterization of protruded type of esophageal neoplasm and provides reliable information relevant to patients treatmen.%目的:分析食管腔内不同大小隆起性肿瘤的数字化低张双重造影X线征象,提高对该病的诊断水平.方法:回顾性分析经数字胃肠机行低张双重对比造影发现并经胃镜活检及手术病理证实的102例食管腔内隆起性肿瘤的病例资料,其中恶性74例,良性28例,对不同大小肿瘤X线特点进行汇总分析,找出良恶性肿瘤之间的鉴别点.结果:102例食管腔内隆起性肿瘤中,长径<1 cm者12例,良恶性鉴别点主要以病变轮廓改变和管壁的功能性改变为主,定性诊断符合率为75%;长径1～3 cm者37例,良恶性诊断要点除轮廓及管壁功能改变外,肿瘤的形态、钡荆的涂抹具有重要鉴别作用,诊断符合率为94.6%;长径>3 cm者53例,良恶性肿瘤各自特点更加明显,尤其表现在黏膜和钡剂涂抹方面.定性诊断符合率为95.2%;102例食管腔内隆起性肿瘤定性诊断总符合率为93.1%,随着瘤体的增大,良恶性诊断符合率呈升序排列.结论:数字化低张双重造影在食管腔内隆起性肿瘤的良恶性定性诊断中具有重要价值,诊断符合率高,可为临床治疗提供可靠性参考.