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目的 :探讨早期食管癌的X线征象及误诊原因。方法 :对 38例经细胞学或经胃镜病理活检及低张气钡双对比食管造影综合检查确诊的早期食管癌 ,进行回顾性阅片分析 ,总结了早期食管癌的X线征象。对 12例误诊为早期食管癌的病例 ,分析造成误诊的原因。结果 :38例早期食管癌中 ,食管造影检查为阴性 9例(2 3 .7% ) ,其余 2 9例有如下X线征 :局限的食管粘膜增粗、中断、迂曲 ;形成小溃疡 ,小的充盈缺损 ;食管壁局限性僵硬 ;钡剂在病变处流速减慢 ,呈现滞留。误诊原因主要为 :照片质量欠佳或食管粘膜钡剂涂抹不好 ,造成粘膜皱襞的“紊乱”或“中断”。结论 :早期食管癌X线征象微细 ,漏诊、误诊率高 ,低张气钡双对比食管造影可显著提高早期食管癌的X线征象显示。X线、胃镜及细胞学检查相互补充 ,以提高早期食管癌的诊断准确率
Objective: To explore the X-ray signs and misdiagnosis reasons of early esophageal cancer. Methods : 38 cases of early esophageal cancer diagnosed by cytology or by gastroscope biopsy and double-contrast esophageal radiography combined with low-grade gastritis were retrospectively reviewed and the X-ray signs of early esophageal cancer were summarized. For 12 cases misdiagnosed as early esophageal cancer, analyze the causes of misdiagnosis. Results: In 38 cases of early esophageal cancer, esophagogram was negative in 9 cases (23.7%). The remaining 29 cases had the following X-ray signs: limited esophageal mucosal thickening, interruption, and distortion; small ulcers formed, small Filling defect; limitations of the esophageal wall stiffness; tincture slowed down in the lesion, showing stagnation. Misdiagnosis is mainly due to: poor photo quality or poor application of esophageal mucosal liniment, causing mucosal folds “disordered” or “disrupted.” Conclusion : The early X-ray findings of esophageal cancer are very small. The rate of missed diagnosis and misdiagnosis is high. Low contrast and double contrast esophageal radiography can significantly improve the early X-ray imaging of esophageal cancer. X-ray, gastroscopy and cytology complement each other to improve the diagnostic accuracy of early esophageal cancer