International Journal of Anatomy Radiology and Surgery (Jul 2016)
The Role of MDCT in Oesophageal Cancer
Abstract
Introduction: MDCT plays an important role in detecting various finding of locally advanced carcinoma oesophagus and metastasis, which helps the surgeons to decide the line of management. Present study describes various finding of oesophageal carcinoma on CT to aid in its diagnosis and staging. Aim: The aim of our study is to evaluate and describe the various Multi Detector Computed Tomography findings of carcinoma oesophagus to aid in its diagnosis and staging. Materials and Methods: After ethical clearance, a prospective study was carried out in the Department of Radiodiagnosis, BMC & RI, Bangalore from October 2014 to September 2015. After obtaining consent, 37 patients presenting with clinical symptoms and signs pertaining to carcinoma of oesophagus, who underwent prior endoscopic biopsy, were studied with Multi Detector CT scanner (Siemens somatom emotion- 6 slice CT) using thin sections. Oral and IV contrast was used. Three dimensional reconstructions were done and various CT findings of oesophageal cancer studied. The diagnosis and staging confirmed by post-operative histopathology. Results : Carcinoma oesophagus was commonly seen in age group between 50 to 60 years (59.5%) with males (51.3%) more commonly affected than females (48.6%). All patients predominantly presented with dysphagia. Alcohol and smoking was the associated risk factor. The lower 1/3rd of oesophagus affected more commonly compare to other parts. The wall thickness in majority of the cases measured between 10-20mm (83.8%). T3N0Mx was the most common staging found in CT (56.7%).16.2% cases presented with metastasis. Squamous cell carcinoma (86.5%) was the most common histopathological type presented. Twenty six patients got operated out of 37 and CT staging was compared with the post operative histopathological staging. The sensitivity of CT-scan for ‘T’ stage were 73.0%, in ‘N’ stage 80.7% and in ‘M’ stage being 100%. Conclusion: CT-scan is excellent in the diagnosis of distant metastasis and lymphadenopathies. Thus, evaluation of various CT findings and preoperative staging of carcinoma oesophagus will help to decide management of these patients. Hence, CT plays an important role in detecting and staging carcinoma oesophagus.
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