The Characteristic Of Lymph Nodes In The Mediastinal Detected By Contrast-enhanced MSCT In Patients With Esophageal Carcinoma

Objective:To analyze the difference of lymph nodes in the mediastinal detected by contrast-enhanced MSCT and the appropriate short track of lymph node metastasis in patients with esophageal carcinoma in the mediastinal different station..Materials and Methods:A total of 156 patients with thoracic esophageal carcinoma underwent spiral CT before surgery. Patients who had received prior anticancer treatment were excluded . In order to contrapose with pathology after operation,mediastinal lymph nodes stations were:paratracheal,subcarinal,subaortic,paraesophageal,left hilar,left pulmonary ligament. It was lymphadenectomy in the subcarinal,paraesophageal,left hilar,left pulmonary ligament; it was sampling in the paratracheal,subaortic .CT methods: 7.5 mm slice thickness.lymph nodes were sought, and the number, size, character, and precise location of the nodes were recorded. The results of reviewing CT images were compared prospectively in relation to pathologic.Results: In a sample of 156 cases, 878 lymph nodes were dissected in the mediastinal including 126 metastasis lymph node ,229 no metastasis lymph nodes were detected by CT,the detection rate is 26.08%.77 metastasis lymph node were detected by CT , the detection rate was 66.11%;152 no metastasis lymph node were detected by CT , the detection rate is 20.21% (p<0.001). paratracheal,subcarinal,subaortic,paraesophageal,left hilar,left pulmonary ligament,these stations detection rate respectively were : 55.36%,63.95%,100%,15.26%,12.5%,3.23%( p<0.001). The majority of LNs detected by CT located at subcarinal, followed by subcarinal and paratracheal,and the lower detection were paraesophageal and left hilar , the lowest left pulmonary ligament; Becouse of the lower detection and lymph node amount dissected in other stations ,only the relationship of short axis and metastasis in the subcarinal and paratracheal were inwestigated.28 metastasis lymph nodes were dissected in the paratracheal station, 27 lymph nodes were in the total positive staions,20 metastasis lymph nodes were detected by CT,and 11 no metastasis.Through analysis of the ROC curve, the accuracy was the best,when the standard of lymph node metastasiswas larger than 7mm,and the sensitivity and specificity were 85%,72.3%;44 metastasis lymph nodes were dissected in thesubcarinal station, 32 lymph nodes were in the total positive staions. 24 metastasis lymph nodes were detected by CT in the total positive staions,3 metastasis lymph node were detected with 2cm short axis and character with round the central low-density in the not total positive staions, 177 no metastasis.Through analysis of the ROC curve, the accuracy was the best, when the standard of lymph node metastasis was larger than 1.3cm,and the sensitivity and specificity were74.07%,69.84%.Conclusions: The detection rate of no metastasis lymph nodes was lower in the mediastinal,the detection rate of metastasis lymph node was higher by contrast-enhanced MSCT with 7.5 mm slice thickness in patients with esophageal carcinoma; the detection rate of the each station was not different; The standard of lymph node metastasis was not same in different station in the mediastinal.