Imageology esophageal cancer examination method (a) x-ray examination
Barium meal examination in the diagnosis of esophageal neoplasms, a simple, practical and effective method. X-ray examination can clearly anatomical lesion, nature, scope, extent and relationship with the surrounding organs, thereby contributing to the clinical stage and the choice of treatment. X-ray examination, although the main method of diagnosis of esophageal cancer, but early diagnosis of cancer, there are still some difficulties, minor lesions sometimes can not find, or find the exception and not qualitative. Therefore, should be used with X ray and esophagoscopy way to make a correct diagnosis.
Esophageal barium meal examination, routine in the fasting, usually in 4 hours before angiography banned diet. Barium meal is not served in the past, the first perspective of the chest, observed lung, heart, great vessels and mediastinum without lesions. Perspective on the abdomen and then, pay attention to the stomach bubble size, shape, presence or absence of gastric bubble soft tissue mass.
(1) commonly used in routine examination, esophageal barium meal examination to take a more upright axis perspective, if necessary, take lying. Lateral cervical esophagus to the observation is good, thoracic esophagus using the right, left anterior oblique standing position to observe the esophagus more filling, and emptying through the situation, with emphasis on mucosal changes. Shows the location of lesions in the best radiography can be taken as, and mucous membranes as filling. Cardia was observed from esophageal entrance. The traditional filling the esophagus and mucous membranes, as still as simple and effective method, but easy to miss small lesions.
(2) double contrast barium enema in the service prior to intramuscular injection of antispasmodic agents, such as anisodamine (654-2), or buscopan 20mg, 55 ~ 18min after the swallow some water foam, then serving barium to form a double contrast; or against blowing the same time only in the barium meal swallow gas to form a double contrast. Double-contrast observation of esophageal wall are conducive to the relaxation degree of understanding of the whole wall Shipi light, soft, shows a small change in mucous membrane, tumors and found a small shallow ulcers; lesions form in the display, profile and range of disease, etc., than superior to conventional inspection methods.
Esophageal cancer in Imageology inspection methods (b) CT scan
Surrounded by a layer of fat surrounding the esophagus, so CT can clearly show the shape of the esophagus, the esophagus can show the relationship with the neighboring mediastinal organs. Structure of normal esophagus and adjacent fat layer between the boundaries clear, or if the entire blurred, then the lesion exists. In esophageal cancer patients, the use of CT scanning for the diagnosis of cancer has some limitations, but is more useful for cancer staging. By CT scan can show the extent of tumor outside the invasion, lymph node and other organ metastasis. CT scan of esophageal cancer can help to estimate surgical resection, to avoid unnecessary surgical exploration, to help determine the surgical approach and the best design for the radiation oncology program. Patients after treatment, followed up by CT can be observed metastasis. Esophageal wall thickness due to different expansion levels vary, but usually less than 3mm; more than 5mm, should be considered abnormal.
CT scan method: fasting routine inspection. Patient supine position, continuous scanning, scan to swallow a bite or two in the contrast agent (1% diatrizoate) or air, to show lesions in the esophageal lumen. CT scan before the intramuscular injection of antispasmodic agents, contribute to expansion of the normal section of the esophagus and clear lesions, and then intravenous contrast agent for enhanced scanning, to show blood vessels and lymph nodes. Entrance from the esophagus on esophageal start scanning, to the abdomen, should include the liver. According to local amplification can be like, to best show esophageal lesions and surrounding tissue.
Imageology esophageal cancer examination method (c) MRI
Since the mid-80s since, MRI increasingly widespread in clinical application. Because of its good features distinguish between the various organizational structures that can simultaneously coronal, sagittal and transverse scanning feature, which can show the size of the tumor, invasion, and the scope, whether it invades adjacent tissues and organs, with or without lymph node and distant metastasis. Therefore, in the staging of esophageal cancer, MRI can provide more information. It can help select the treatment method, patients were followed up also useful. MRI aspects of the esophagus, a few reports at home and abroad, to be further explored.
Scanning Method: Patient supine position. Medical Oncology hospitals Technicare company 0.6T superconducting magnet MRI machine, slice thickness 10mm, spacing 2mm, made transverse, coronal and sagittal multi-planar imaging. With SE (spin echo sequence), Tl-weighted image with the TR300-500 ms, TE 21-32 ms, 2-4 times the average; T2-weighted image with TR 2 000ms, TE32, 64, 96,128 ms multi-echo sequence , twice the average of all scan takes about 30-40 min.
Imageology esophageal cancer examination method (d) B scan ultra-
In esophageal cancer patients for neck and upper mediastinal ultrasonography, increased lymph node can be observed. Shown as enlarged lymph nodes metastasis [greater than 5X10 (mm2)], round, clear boundary, low echo, internal echo thick. Lymph nodes less than 5mm, thin and uniform internal echo, the phenomenon goes by without the surrounding tissue, compared with non-malignant.
Endoscopic ultrasound in the early 80s come out, is to install the included miniature endoscopic ultrasonic probe to the top. It can observe the surface of the digestive tract mucous membrane lesions, but also understand the disease through ultrasound scanning depth, the relationship with the surrounding organs in and around the enlarged lymph nodes, helping to develop esophageal cancer early diagnosis and treatment plan.
Imageology esophageal cancer examination method (e) Imageology check the value and selection methods
Overall, esophageal barium meal can be a good indication of changes in the lumen and mucosal carcinoma in length. CT can show tumor extension to the cavity case. Generally when suspected esophageal cancer, esophageal barium meal should be checked, if necessary, further CT scan.
CT scan can be used as supplementary barium meal examination, but can not replace barium meal. CT examination of the value of esophageal cancer:
(1) shows the relationship between the esophagus and adjacent tissues in Medical Oncology Hospital, and a group of surgical cases reported in the literature, CT scan can show a good relationship between the esophagus and adjacent structures in the CT scan, see the esophagus and the adjacent tissue boundaries ambiguous cases , the majority of cases of child cancer patients and found that adhesion or infiltration around; but two examples of cancer patients found no adhesion with the surrounding, to analyze the reason may be that the patient weight loss, lack of mediastinal fat to an extent which rendered the comparative lack of the esophagus and mediastinum organizational boundaries unclear.
(2) estimated whether the surgical removal of cancer cases in Medical Oncology Hospital, CT examination, see the descending aorta and the esophageal mass and prevertebral soft tissue boundaries blurred; surgery found that the tumor with a long descending aorta firmly together, can not be removed . See also 1 case CT scan of esophageal cancer at the anterior and carina and left posterior wall of the right main bronchus boundaries unclear, posterior and lateral wall and prevertebral soft tissue and part of the aorta boundaries blurred; operation was cancer and the left lung invading the door, below the carina and right main bronchus membranous, not
removed. Esophagus and unclear boundaries often expressed around the lesion, but not necessarily with inoperable.
(3) followed up in a CT examination before the evaluation of esophageal cancer are seldom effective and not sensitive, CT scans were followed up for a better way to check the chest and abdomen. Observation of the efficacy of radiotherapy and chemotherapy to check for recurrence and mediastinum, lymph nodes and other parts of the Ministry of intrinsic transfer.
B-scan and MRI examination of the value of esophageal cancer is still being observed, essentially as a supplementary aid. Endoscopic ultrasound is more expensive, although the depth of invasion can be observed, but some difficult through the narrow section needs further observation and research.