头低足高位 X 线造影对食管胃吻合口瘘的诊断价值-论文.pdf

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1、医学影像学杂志2015年第25卷第6期JMedImagingVo1．25No．62015头低足高位X线造影对食管胃吻合口瘘的诊断价值李书新，张殿星，田军。(1．山东省武城县人民医院胸外科山东武城253300；2．山东省医学影像学研究所山东济南250021)【摘要】目的探讨头低足高位x线造影检查对临床疑诊食管胃吻合口瘘患者的诊断价值。方法对收集的21例临床疑诊食管胃吻合口瘘的患者行常规x线造影检查和头低足高位x线造影检查，患者先口服非离子型对比剂，对于未显示吻合口瘘的患者再口服稀钡，分别记录常规造影和头低足高位检查吻合口瘘的检出情况。结果常规非离子型对比剂造影检出吻合

2、口瘘13例，其中9例对比剂未向远处弥散，2例对比剂向纵隔内弥散，2例对比剂弥散入胸膜腔。8例未检查吻合口瘘的患者采用头低足高位造影检查又检出4例吻合口瘘，口服稀钡后又检出1例。结论头低足高位X线造影检查能够显著提高临床疑诊食管吻合口瘘的检出率，为临床后续治疗提供重要的影像学依据。【关键词】造影检查，x线透视；对比剂；食管胃吻合口瘘中图分类号：R655．4；R814．43文献标识码：A文章编号：1006—9011(2O15)06—1041-04Diagnosticvalueoffoot-highobliquepositionradiologicalcontrastex

3、aminationindetectionofgastroesophagealanastomoticleakLIShu—xin。ZHANGDian—xing。。TIANJun1．DepartmentofThoracicSurgery，WuchengPeople’SHosipitalofShandongProvince，Wucheng253300，P．R．Chi—na2．ShandongMedicalImagingResearchInstitute，A}{tliatedtoShandongUniveristy，Jinan250021，P．R．China[Abstract

4、]ObjectiveToexplorethediagnosticvalueoffoot—highobliquepositionradiologicalcontrastexaminationindetectionofprobablegastroes0phagea1anastomoticleakofpatients．Methods21casesofclinicallysuspecteddiagnosisofgastr0es0phagea1anastomoticleakwerecollected．Allcasesunderwentconventionalradiologi

5、calcontrastexaminationandfoot—highobliquepositionradiologicalcontrastexamination．First，thepatientstakenorallynonioniccontrastagents，andthentakenorallydilutebariumforthepatientswhowerenotshownthegastr。esophagealanastomoticleak．Werecordedtheresultsofconventionalradiologicalcontrastexamin

6、ationandfoot—highobliquepositionradiologicalcontrastexaminationindetectingthegastroesophagea1anastomoticleak，respectively．Results13casesofgastroesophagealanastomoticleakwereacquiredwithconventionalradiologica1contrastexamination．Thecontrastagentswerenotdiffusedtodistantin9ca—ses，diffus

7、edintothemediastinumin2cases，anddiffusedintothepleuralcavityin2casesofthem．4casesofgastroe—sophagealanastomoticleakwereacquiredwithfoot—highobliquepositionexaminationin8patientswhowerenotdetectedtheanastomoticleakwithconventionalradiologicalcontrastexamination，and1anastomoticleakwasa