目的 探讨多层螺旋CT在食管 癌手术切除可行性以及预后评估中的价 值。方法 回顾分析2015年1月-2016年 10月我院108例食管癌患者术前多层螺 旋CT资料，分析多层螺旋CT对手术可 行性、肿瘤浸润、术前临床分期诊断准 确性以及螺旋CT显示指标和临床分期对 预后的影响。结果 108例患者术前多层 螺旋CT评估均可进行手术切除治疗，实 际有3例不能进行手术，其评估准确率 为97.22%；多层螺旋CT气管、支气管 受侵诊断敏感性为90.00%，特异性为 88.24%，准确性为88.89%;心包受侵诊 断敏感性为91.67%，特异性为93.05%， 准确性为92.59%；主动脉和相邻大血管 受侵诊断敏感性为89.74%，特异性为 92.75%，准确性为91.67%；多层螺旋CT 分期诊断准确性为89.81%；多层螺旋CT 检测病变长度≤5.0cm、病变最大直径 ≤3.0cm以及临床分期I+II期患者生存率 显著较高。结论 食管癌患者行术前多层 螺旋CT检查，肿瘤浸润和术前临床分期 诊断准确性高，且螺旋CT显示指标和临 床分期可用于手术预后评估。

Objective To investigate the value of feasibility and the prognosis evaluation of multi-slice spiral CT in esophageal carcinoma resection. Methods The preoperative multi-slice spiral CT data of 108 patients with esophageal carcinoma treated in the hospital from Jan. 2015 to Oct. 2016 were retrospectively analyzed. The value of multislice spiral CT in evaluating the feasibility of surgery, diagnosis of tumor invasion and preoperative clinical stage, and the effect of indexes displayed by spiral CT and clinical stage on the prognosis were analyzed. Results Multi-slice spiral CT evaluation showed that all 108 cases of patients could be given the surgical resection while actually there were only 3 cases without being given the surgery, and the accuracy of multi-slice spiral CT evaluation was 97.22%. The sensitivity, specificity and accuracy of multi-slice spiral CT examination were 90.00%, 88.24% and 88.89% respectively in diagnosis of tracheal and bronchial invasion, and were 91.67%, 93.05% and 92.59% respectively in diagnosis of pericardial invasion, and 89.74%, 92.75% and 91.67% respectively in the diagnosis of aorta and adjacent large vascular invasion. The accuracy of multi-slice spiral CT in diagnosis of clinical stage was 89.81%. Multi-slice spiral CT detected that the survival rate of patients with lesions length ≤ 5.0cm, the maximum lesion diameter ≤ 3.0cm and the clinical stage with I and II were significantly higher. Conclusion The accuracy rates of multislice spiral CT are high in the diagnosis of tumor invasion and preoperative clinical stage of patients with esophageal carcinoma, and the spiral CT indexes and clinical stage can be used to evaluate the prognosis of surgery.