Development of New Imaging Diagnostic Tool for Esophageal Cancer : Virtual Esophagogram and Endoscopy Produced by High-resolution 3D-CT

开发食道癌新影像诊断工具：高分辨率3D-CT制作的虚拟食道图和内窥镜

• 批准号: 14570870
• 负责人: MURAYAMA Sadayuki
• 金额: $ 2.05万
• 依托单位: University of the Ryukyus
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2004
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14570870/
• 关键词: Esophageal Cancer; Esophagocardiac Junction; Gastric Cancer; Three-dimensional CT; Multidetector CT; Leiomyoma; 組織型; 高精度CT; 低酸素; 放射線治療; 免疫染色; 遺伝子発現; 増殖活性; 癌遺伝子; 癌抑制遺伝子; 高精細CT; ウイルス感染; CT; 仮想食道造影; 仮想内視鏡; 食道伸展; 持続性空気注

Because of stricture of esophagocardiac junction (ECJ), a tumor located in the ECJ could not be well imaged by conventional computed tomography (CT).The purpose of this study was to investigate the utility of the combination of prolonged air infusion as an esophageal dilatation method and virtual esophagogram or endoscopy produced by multi-slice CT for diagnosis of ECJ tumors.The subjects were 15 examples diagnosed by barium study or endoscopic examination including 5 gastric cancers, 4 carcinomas present in ECJ, 4 esophageal cancers, and 2 leiomyomata.Prolonged air infusion CT imaging was performed as follows : First, an endonasal 5-12Fr. tube was placed in the lower esophagus. Subsequently, contrast enhanced CT was performed with 40sec scan delay, 1.25 mm collimation, 3 or 5.5 pitch, and 0.6mm reconstruction while air of 400 mL was injected for persistence in 10mL/sec from the tube in the esophagus beforehand.Compliance was evaluated with three phases. It was "excellent" for the case that lumen was confirmed in esophagus, ECJ, and stomach, each ; The case that lumen was not confirmed only in ECJ was good ; The case that the lumen at esophagus or stomach was not confirmed is poor. Furthermore, visualization ability of a lesion was evaluated in MPR, virtual esophagogram, and endoscopy.Poor was 1 example(7%), excellent 6 (40%), good 8 (53%) regarding compliance of lumen results. Any tumor was identified in MPR, virtual esophagogram, and endoscopy in all 15 cases (including lesions with less than 6mm in diameter). Virtual esophagogram or MPR was able to depict development of the tumor that hang over ECJ in 10 cases except small 2 lesion equal to or less than 2cm in diameter.In conclusion, it was suggested that prolonged air infusion 3D-CT imaging improve visualization ability of ECJ lesions.

由于食管贲门交界处（ECJ）狭窄，本研究的目的是探讨联合使用长时间空气灌注作为食管扩张方法和多通道仿真食管造影或内窥镜检查的实用性，15例经钡剂造影或内镜检查确诊的ECJ肿瘤，其中胃癌5例，ECJ内癌4例，食管癌4例，延长空气灌注CT成像如下进行：首先，使用5- 12 Fr的鼻内注射器。在食管下部放置了导管。扫描延迟40 s，层厚1.25mm，螺距3或5.5，重建0.6mm，食管内注入空气400 mL，以10 mL/s的速度持续增强。食管、ECJ和胃均确认管腔的病例为“极好”;仅ECJ未确认管腔的病例为良好;食管或胃未确认管腔的病例为差。此外，还通过MPR、虚拟食管造影和内窥镜检查评价了病变的可视化能力，管腔结果的顺应性较差1例（7%），优秀6例（40%），良好8例（53%）。所有15例患者均在MPR、仿真食管造影和内窥镜检查中发现任何肿瘤（包括直径小于6 mm的病变）。10例ECJ上方肿瘤的三维CT增强扫描或MPR均能显示肿瘤的发展过程，但2例直径≤ 2cm的小病灶除外，提示长时间充气3D-CT成像可提高ECJ病变的显示能力。