[Ultrasonic characteristics of metastatic lesions of the lymph nodes in esophageal cancer].
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Biomedical subjects
Publications and source records attributed to S A Sedykh.
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Computed tomography (CT) findings were compared with operative ones for 50 patients with esophageal and proximal gastric cancer. In diagnosis of metastases to the upper abdominal and retroperitoneal lymph nodes ST sensitivity reached 93.3%, specificity 85% and accuracy 90.3%. The best diagnostic results were obtained in detection of metastases to the nodes of the celiac trunk branch and paraaortal fat (94.2%). Lower CT resolution appeared in diagnosis of perigastric node metastatic involvement in the primary tumor location in the proximal stomach.
The examination of 170 patients with cancer of the esophagus and proximal stomach made it possible to specify x-ray, ultrasonic and CT signs of cancer metastases to the upper abdomen and retroperitoneum. A scheme of radiodiagnosis of these metastases is suggested. The diagnostic value of x-ray, echography and CT was considered in relation to various lymph nodes involvement.
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The paper is based on analysis of the results of ultrasound investigation of 67 patients with esophageal cancer with metastatic involvement of abdominal and retroperitoneal lymph nodes verified at operation. For effective diagnosis of these changes during ultrasound scanning one should observe the main methodological principles and methods including polyprojection, polyposition and staging of investigation. It should be noted that unchanged lymph nodes cannot be visualized.
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X-ray and endoscopic investigations were compared in 80 operated on patients to estimate the role of the x-ray method for a choice of adequate therapeutic tactics for esophageal cancer patients. Operations were explorative or palliative resulting from the involvement of the tracheobronchial tree in a tumor process. The efficacy of the x-ray method in the detection of tracheal compression by an esophageal tumor is higher than that of tracheobronchoscopy which in its turn, has its advantages in the determination of tumor spreading to the left major bronchus.
The prognostic and clinicodiagnostic significance of an x-ray picture of ulceration in esophageal cancer was established on the basis of the correlation of x-ray, morphological, endoscopic, operative findings and the control x-ray results following radio- and chemotherapy. Altogether 70 patients were investigated. X-ray symptoms were classified; their significance in the choice of optimum therapeutic tactics was defined.
Computer-aided tomographic (CT) examination of 94 patients with esophageal cancer was carried out. Densitometric analysis of computer image of esophageal tumors making use of profile density histograms is presented for the first time. Objective graphic criteria for assessment of the depth of tumor invasion have been developed. CT results were correlated to intraoperative findings and data of histological examination of removed tumors. The sensitivity of the method in assessment of esophageal cancer dissemination was 97.7%, specificity 93.4%.