電腦斷層攝影於食道癌分期之應用－初步報告

APPLICATION OF CT IN STAGING OF ESOPHAGEAL CARCINOMA-PRELIMINARY REPORT

謝明仁(Ming J. Hsieh) ； 楊建芳(Chien F. Yang) ； 張遵(Tsuen Chang) ； 黃敏雄(Min H. Huang) ； 乾光宇(Kwang-Yu Chien)

《中華放射線醫學雜誌》 8卷3期 (1983/09) Pp. 213-219

摘要

自民國71年7月至72年4月間12例曾做電腦斷層攝影之食道癌病案，其中有10例接受開胸曁剖腹手術之，複閲術前CT影像所見與手術後之結果相互對照作一比較，以瞭解CT對於食道癌腫瘤大小及其延伸侵犯周圍組織結構的情形之實在性與可靠性。依照CT食道癌分期的準據，10例中第二期的有4例，第三期者有6例。從這10個病例回顧CT影像所見，初步結果得悉CT判斷病灶侵襲隣近周圍組織如主動脈、氣管或主支氣管有很高的預測準確性，但對於食道旁、後縱隔淋巴結或上腹、左胃淋巴結的病灶轉移，就我們所使用之電腦斷層掃描儀Delta 50 FS CT判讀的可靠性很低。但若針對病灶能否割除，從CT橫斷面解剖學構造的特性，偵測主動脈與支氣管被侵犯的情形，CT不失爲一很有效的、不具侵襲性的檢査功具，可以應用作爲食道癌之分期，免除不必要的手術，着手擬一放射治療的計畫。今提出10例研究之初步報告以供參考。

並列摘要

Between July 1982 and April 1983, 12 cases of epidermoid carcinoma of the esophagus with preoperative computed tomography were reviewed. Ten patient had received both exploratory thoracotomy and laparotomy. The CT findings were correlated with findings at surgery and histopathology. On the basis of CT findings, esophageal carcinoma was classified into four stages according to the criteria of Moss et al. There were 4 cases in stage II. and 6 cases in stage III in our series. Results indicated that CT staging for evaluation of the tumor size and local extraesophageal extension correlated closely with surgical findings. CT appearance correctly predicted the presence or absence of aortic invasion in 9 of 9 cases (one was indeterminate), CT was quite insensitive in detecting metastatic periesophageal & other regional lymph nodes by using our Ohio delta 50 FS scanner. From the experience of these 10 cases, we found CT to be a good tool for non-invasively assessing the extent of esophageal Ca. and to determine its resectability. This application can prevent unnecessary surgery in inoperable patients and allows to plan a radiation therapy.