X-ray examination of esophageal cancer

Esophageal barium meal examination is the most convenient, practical and effective method for diagnosing esophageal cancer. Through X-ray examination, qualitative, localized and stereotyped diagnosis can be obtained, and the extent of invasion of the lesion into surrounding organs can be understood, which is helpful for formulating clinical treatment plans. Esophageal X-ray barium meal examination should be closely combined with esophageal cytology, esophageal endoscopy and B-ultrasound to improve the accuracy of diagnosis.

1. Preparation before the examination

Patients are prohibited from eating or drinking 2 to 4 hours before the examination to avoid food residues in the esophagus that may affect the diagnosis. Secondly, it can reduce the secretion of esophageal mucus, so that the barium slurry adheres well to the esophageal mucosa and the esophageal mucosa is clearly imaged. It is extremely important for the examination of early esophageal cancer.

2. Inspection method

Before performing esophageal contrast imaging, chest and upper abdominal fluoroscopy must be performed to understand whether there are normal variations or dense shadows of masses in the esophageal passage organs to avoid misdiagnosis. Multi-axis esophageal fluoroscopy is used, and observation is performed in an upright or supine position. Left and right oblique point films are taken. Anteroposterior films are best used for cervical esophageal lesions. Contrast agents can generally be used with more viscous barium agents, which have better effects. If the patient has difficulty swallowing, dilute barium agents should be used. If esophageal fistula formation is suspected clinically, iodine contrast agents should be used. For routine esophageal barium meal contrast imaging, the entire esophageal mucosal phase and filling phase must be taken, and abdominal compression can also be used for contrast imaging.

Since the flow rate of barium in the esophageal lumen is too fast, it is not conducive to detailed observation and is often easy to miss the diagnosis. Abdominal compression can reduce the flow rate of contrast agent, so that the contrast agent stays in the esophagus for a longer time, which is conducive to detailed observation. For upper esophageal tumors, the examination is more satisfactory. Double contrast imaging is the simplest method, that is, the patient swallows air immediately after swallowing barium. Double contrast contrast agents are often used, or 654-2 is injected intramuscularly before double contrast imaging to eliminate esophageal peristalsis and become low-tension imaging. The observation of esophageal wall relaxation and esophageal mucosal folds is more satisfactory, which is conducive to the discovery of small tumors.