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Imaging presentations of esophageal perforation
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- Author:
- No author available
- Journal Title:
- WORLD CHINESE JOURNAL OF DIGESTOLOGY
- Issue:
- 3
- DOI:
- 10.3969/j.issn.1009-3079.2009.03.017
- Key Word:
- 食管;破裂;放射学;诊断
Abstract： 目的: 探讨食管破裂的影像学表现及不同影像学检查对于临床治疗的意义.方法: 搜集2002-06/2008-10我院21例临床诊断食管破裂的临床及影像学资料.其中胸部X线检查10例, 颈椎X线检查2例, 食道造影检查11例(其中碘水造影7例, 钡剂造影4例), 9例患者接受螺旋CT扫描(其中2例增强扫描). 分析患者的综合影像学表现.结果: 10例胸片, 发现液气胸4例, 胸腔积液4例, 3例合并肺部感染; 7例出现纵隔改变, 其中纵隔气肿3例, 纵隔增宽3例, 纵隔内气液平面1例; 4例出现颈、胸壁皮下气肿. 2例颈椎侧位片中, 1例提示颈前区软组织增厚, 另1例发现颈部含液气平面囊腔. 11例食管造影检查中, 除2例碘剂造影阴性外, 9例均表现造影剂溢出食管外; 4例显示黏膜下造影剂积聚. 9例CT检查, 5例显示破裂区食管周围可见不规则软组织影, 内呈气体或液体混杂密度, 4例显示食管壁局限不规则增厚, 4例显示纵隔或膈下脓肿形成; 2例增强CT提示脓肿形成, 脓肿壁环行强化.结论: 食管造影检查及CT检查是诊断食管破裂的主要影像学手段, 而通过CT观察组织炎性改变对于外科治疗方式的选择尤为重要.
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