Radiological evaluation on invasive extent of adenocarcin-oma of esophagogastric junction.
- Author:
Lei TANG
1
;
Jiazheng LI
2
Author Information
1. Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing 100142, China, Email:terrytang78@163.com.
2. Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing 100142, China.
- Publication Type:Journal Article
- MeSH:
Adenocarcinoma;
classification;
diagnostic imaging;
pathology;
surgery;
Contrast Media;
Esophageal Neoplasms;
classification;
diagnostic imaging;
pathology;
surgery;
Esophagogastric Junction;
diagnostic imaging;
pathology;
surgery;
Humans;
Magnetic Resonance Imaging;
Neoplasm Invasiveness;
Neoplasm Staging;
Stomach Neoplasms;
classification;
diagnostic imaging;
pathology;
surgery;
Tomography, X-Ray Computed
- From:
Chinese Journal of Gastrointestinal Surgery
2019;22(2):119-125
- CountryChina
- Language:Chinese
-
Abstract:
The accurate judgement of the upper and lower borders of the adenocarcinoma of esophagogastric junction (AEG) by radiology can facilitate the decisions on surgical approach and staging criteria. X-ray double contrast radiography, CT and MRI are the common modalities. The accuracy of X-ray double contrast radiography in determining the invasion length of esophagus and the central point of gastric infiltration can be improved by standardized pretreatment, combination of multiple contrast methods such as double contrast and flow-coating procedure, and combination of multi-angle observations such as conventional frontal, left /right anterior oblique and supine right posterior oblique position. Abdominal enhanced CT is the imaging method recommended by clinical guidelines for the radiological examination of AEG. The relative position of the central point of the tumor from 2 cm line can be determined through the combination of measurement and formula calculation on multi-planar reconstructed CT images. The "three-layer four-type" classification can provide reference for the selection of abdominothoracic incision. The direct demonstration of the tumor extension can be achieved through the CT curved planar reconstruction by drawing lines along esophagus to stomach. The combination of multiple sequences of MRI is helpful to determine the extension of the lesions. In the future, more radiological studies are needed to establish criteria with high accuracy, repeatability and convenient operation,and to assist clinical evaluation of AEG invasion.
