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Imaging characteristics of esophageal cancer in multi-slice spiral CT and barium meal radiography and their early diagnostic value.

Background
To explore the imaging characteristics of esophageal cancer in multi-slice spiral CT (MSCT) and barium meal radiography and to analyze the value of the two examinations alone or in combination for cancer staging diagnosis.


Methods
The clinical data of 87 patients with esophageal cancer admitted to our hospital from June 2018 to June 2020 were retrospectively analyzed. According to the different examination methods, they were divided into a barium meal group (n=28 cases, X-ray barium meal radiography), an MSCT group (n=29 cases, MSCT examination), and a combined group (n=30 cases, barium meal + MSCT). The imaging characteristics from the barium meal radiography and MSCT alone versus their combined results were compared with the pathological examination results to analyze their accuracy in diagnosing esophageal cancer staging.


Results
Of the 87 cases, the esophageal cancer lesion sites were as follows: 23 cervical cases, 20 upper thoracic cases, 21 middle thoracic cases, and 23 lower thoracic cases. The X-ray barium meal examination of esophageal mucosa showed irregular filling of the esophagus. The esophageal wall was stiff or jagged, the lumen was narrow, and it was difficult for the barium to pass, the mucosa was discontinuous. The CT scan showed irregular thickening of the esophageal wall, eccentric and concentric stenosis of the esophageal cavity, and the upper part of the esophagus showed different degrees of expansion. The trachea and bronchi were invaded, deformed, and displaced under compression. The diagnostic staging results of the barium meal group and MSCT group were inconsistent with the pathological results (Kappa =0.105, 0.112; P>0.05). The diagnostic staging results of the combined group were in good agreement with the pathological results (Kappa =0.769). In addition, the accuracy of the combined group in the diagnosis of stage III-IV esophageal cancer among the three groups was significantly higher than that of the barium meal group and MSCT group alone (P<0.05).


Conclusions
MSCT and barium meal radiography clearly display the imaging features of esophageal cancer and can provide reliable imaging evidence for preoperative diagnosis; the combination of both measures can effectively improve the accuracy of early diagnosis for esophageal cancer.