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目的 探讨食管癌切除术后正常胸部改变的CT表现。方法 回顾性分析了 83例食管癌切除后食管、胃弓上吻合病例随访中的CT及临床资料。结果 胸腔胃自弓上与食管残端吻合后 ,与左侧胸腔内后方呈囊袋状自上而下走行 ,在左膈肌近中心腱部位的切口移行入腹腔 (95 2 % )。吻合口充气征常见 (78 3 % ) ,其中可见防止胃液返流的人工瓣膜 ,呈结节或瓣膜样软组织影突向腔内 (57% ) ;胸胃的中下部前壁相邻肺可见盘状肺不张 (51 8% ) ,胸胃内侧壁一般光滑 (74 7% ) ,部分可见胃黏膜皱襞症 (2 1 / 83 ,2 5 3 % ) ;左侧胸腔胃内均可见假肿瘤征 (1 0 0 % ) ,为突向胃内的软组织肿块影 ,中心部脂肪低密度影为其特征 ;4例胸胃部分突入纵隔或右侧胸腔 (4 82 % )。结论 CT胸部扫描可准确反映食管癌切除后 ,食管、胃弓上吻合术后的解剖变化及对邻近脏器解剖与功能影响。
Objective To investigate the CT findings of normal chest changes after resection of esophageal cancer. Methods The CT and clinical data of 83 patients with esophageal and gastric anastomosis after resection of esophageal cancer were retrospectively analyzed. Results After the anastomosis of the thoracic cavity and the esophageal stump, the left and right thoracic cavities were pouch-shaped and walked from top to bottom. The incision in the left diaphragmatic muscle near the central tendon moved into the abdominal cavity (95 2%). Anastomotic inflation was common (78.3%), of which artificial valves to prevent reflux of gastric juice were seen, with nodules or valve-like soft tissue projecting into the lumen (57%); (51 8%), the inner wall of the thoracic stomach was generally smooth (74 7%), and the gastric mucosal folds were partially visible (21/83, 25 3%). The left thoracic stomach showed pseudo- tumor sign (100%) were the features of the soft tissue masses in the stomach and the low density of fat in the central part of the stomach. Four cases had part of the thorax or stomach into the mediastinum or the right chest (4 82%). Conclusion CT chest CT scan can accurately reflect the anatomic changes of the esophagus and gastric arch after anastomosis and the anatomic and functional effects on adjacent organs after esophagectomy.