esophagography with barium meal and endoscopic examination are widely used for the diagnosis of esophageal disturbances. Besides them, angiographic examination has recently attracted the interesting discussion of this field, esophageal arteriography is expected to be of importance in investigating the neoplastic extension towards the outside, infiltration to the adjacent organs and metastatic regions of malignancies.
Upon vessels supplying the thoracic and abdominal esophagi, however, little has been written about the pathological changes in esophageal diseases, particularly in cancer.
A newly shaped catheter was desinged by authors and esophageal arteriography was performed with it on 50 cases. The arteriographic findings in esophageal cancer and angioscintigraphies by direct intraarterial injection of
131I-MAA or
99mTc-MAA were investigated to get the following knowledges.
1. The success rate of selective arteriography by using the improved catheter was 93.9% in bronchial artery, 90.9% in proper esophageal artery and 100% in coeliac artery.
2. Out of 46 cases of proper esophageal artery, 44 occured from a left anterior surface. one from a centre and one from a right anterior surface of the descending aorta. All arteries originate at a level of Th 7-Th 9.
3. Subtraction technique was effective to visualize the vascular change at periphery and cineradiography was useful to observe the dynamic status.
4. In cancer of the thoracic esophagus, hypervascularity, tumour stain, irregularity of vessels and arteriovenous shunt were observed in almost the same frequency in both proper esophageal and bronchial arteriographies. On the other hand, these findings were not remarkable in the coeliac artery field. In esophageal cancer localized in at least more than two segments, arteries related showed the changes according to the anatomical position of the disease.
5. All arteriographic findings excluding arteriovenous shunt were observed in the frequency of more than 90%, particularly as high rate as 96.0% so far as hypervascularity concerned. It is, therefore, concluded that esophageal cancer arteriographically belongs to the category of hypervascularity.
6. Angioscintigraphy supported well the arteriography in getting the further information of the morphology of tumour. Macroaggregated albumin was recognized to stay up to 72 hours at the neoplastic region.
The clinical value of esophageal arteriography in both diagnostic and some therapeutic radiology were discussed.
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