X-ray barium meal examination of esophageal cancer

X-ray barium meal examination is one of the important means of diagnosing esophageal and cardia tumors. Because of its simple examination method and little pain for patients, it can not only be used for large-scale surveys and clinical diagnosis of esophageal cancer, but also can track and observe the development and evolution of early esophageal cancer, providing reliable data for the study of early esophageal cancer. During the esophageal barium meal examination, attention should be paid to observing the peristalsis of the esophagus, the relaxation of the tube wall, changes in the esophageal mucosa, esophageal filling defects and the degree of obstruction. Esophageal peristalsis pause or reverse peristalsis, local stiffness of the esophageal wall that cannot fully expand, esophageal mucosal disorder, interruption and destruction, esophageal lumen stenosis, irregular filling defects, ulcer or fistula formation, and esophageal axial abnormalities are all important X-ray signs of esophageal cancer. For patients with early esophageal cancer and obvious obstruction and stenosis of the esophageal lumen, low tension double contrast examination is better than conventional barium meal contrast. X-ray examination combined with cytology and esophageal endoscopy can improve the accuracy of esophageal cancer diagnosis.

① X-ray changes of early esophageal cancer: can be divided into flat type, raised type and depressed type. Flat tumors are flat and sessile, infiltrating along the esophageal wall, with localized stiffness of the esophageal wall, and the esophageal mucosa showing small granular changes or disordered reticular structures. Raised tumors grow and bulge into the esophageal cavity, showing plaque-like or papillary bulges, and ulcers may form in the center. Depressed tumors have erosions and ulcers in the area, showing depressed changes. The lateral position is a serrated irregular shape, and the frontal position is an irregular barium pool with granular nodules inside, showing map-like changes and clear edges.

② X-ray manifestations of advanced esophageal cancer: Medullary type: irregular filling defect is shown on the esophageal film, with the upper and lower edges sloped with the normal border of the esophagus, and the lumen is narrow. The mucosa of the lesion is destroyed, and niches of varying sizes are common. Fungus type: obvious filling defect is shown on the esophageal film, with arc-shaped upper and lower edges, sharp edges, and clear boundaries with the normal esophagus. The mucosal pattern of the lesion is interrupted, and there is partial obstruction of barium passing. Ulcer type: large niches are shown on the esophageal film, and the niches are seen to penetrate deep into the esophageal wall and even protrude outside the lumen contour on the tangent position. If the edge of the ulcer is raised, a "half-moon sign" can be seen. Obstruction is not obvious when barium passes. Stenosis type: the esophageal lesion is shorter, often less than 3 cm, with smoother edges, and local mucosal patterns disappear. Obstruction is more serious when barium passes, and the esophagus at the upper end of the lesion is significantly dilated, showing a ring-shaped or funnel-shaped stenosis. Intraluminal type: The esophageal lumen is widened at the site of the lesion, often in a fusiform expansion, with irregular or polypoid filling defects, and the upper and lower edges of the lesion are relatively clear and sharp, sometimes with clear arc-shaped edges, and barium can pass through. The medullary type is the most common type of advanced esophageal cancer, followed by the mushroom-shaped type, and the other types are less common.