多层螺旋CT检查对食管癌放疗后并发食管瘘小瘘口的诊断价值  

Clinical value of multi-slice spiral CT in the diagnosis of esophageal fistula after radiotherapy for esophageal cancer

作　　者：方涛[1] Fang Tao(Department of Radiology,the Peoples Hospital of Quchou,Quchou,Zhejiang 324000,China)

机构地区：[1]浙江省衢州市人民医院放射科,324000

出　　处：《中国基层医药》2019年第11期1297-1300,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨多层螺旋CT对食管癌放疗后并发食管瘘小瘘口的诊断价值。方法选择2015年1月至2017年2月衢州市人民医院收治的食管癌放疗后疑似并发食管瘘患者30例,通过抽签的方式随机分成A组和B组,每组15例。A组的检测方案为多层螺旋CT(MSCT,Multi-slice CT);B组采用常规食管造影的方式进行检测后诊断,观察两组患者的诊断准确性,并统计漏诊率,对比两组患者发现瘘口、纵隔内积气积液、气胸等造影剂的用量。结果A组采用多层螺旋CT技术后,漏诊率为0%(0/15),显著低于B组[漏诊率为40%(6/15)],差异有统计学意义(χ^2=8.097,P=0.016);A组患者诊断过程中造影剂的用量在诊断隔内积气积液、气胸、肺炎、脓胸时分别为(32.4±4.5)mL、(25.1±3.2)mL、(20.5±2.4)mL、(19.5±12.3)mL,均显著优于B组(t=14.325、15.652、16.534、15.973,P=0.025、0.018、0.013、0.017)。结论采用多层螺旋CT技术加之恰当的后处理方式可以极大地提高食管癌后并发食管瘘特别是小瘘口诊断的准确性,从而对患者的及时治疗起到重要作用,推荐使用。Objective To investigate the application of multi-slice spiral CT in the diagnosis of esophageal fistula after esophageal cancer radiotherapy.Methods The subjects who were suspected to have esophageal fistula after radiotherapy for esophageal cancer admitted to the People's Hospital of Quzhou from January 2015 to February 2017 were randomly divided into A group and B group by means of lottery,with 15 cases in each group.The detection scheme of A group was multi-slice CT(MSCT),and the diagnosis of B group was performed by routine esophagography.The diagnostic accuracy of the two groups was observed,and the rate of missed diagnosis was compared.The amount of contrast agent such as gargle,mediastinal gas accumulation,and pneumothorax was observed.Results After the multi-slice spiral CT technique in A group,the missed diagnosis rate was 0%,which was significantly lower than that of B group(40%),the difference was statistically significant(χ^2=8.097,P=0.016).In A group,the amount of contrast agent used in the diagnosis process were(32.4±4.5)mL,(25.1±3.2)mL,(20.5±2.4)mL,(19.5±12.3)mL in the diagnosis of effusion,pneumothorax,pneumonia and empyema,which were significantly better than those in B group(t=14.325,15.652,16.534,15.973,P=0.025,0.018,0.013,0.017).Conclusion Esophageal cancer complicated with esophageal fistula,especially small fistula is difficult to observe,resulting in missed diagnosis,the use of multi-slice spiral CT technology combined with appropriate post-treatment can greatly improve the accuracy of diagnosis,and thus timely treatment of patients,it is recommended for use.

关 键 词：食管肿瘤 气管食管瘘 体层摄影术 螺旋计算机 放射疗法 

分 类 号：R735.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]