食管息肉的(de)檢查(cha)確診(zhen)主(zhu)要包括影像學檢查(cha)和內(nei)鏡。其(qi)具體內(nei)容如下:
1、食管鋇餐造影
此(ci)項(xiang)檢(jian)查對食(shi)(shi)管(guan)(guan)(guan)(guan)息(xi)(xi)肉的診(zhen)斷仍然存(cun)在一(yi)定困難,有(you)(you)(you)(you)(you)時容易造(zao)成(cheng)漏診(zhen)或(huo)(huo)誤診(zhen),如(ru)果(guo)息(xi)(xi)肉較大(da),在做食(shi)(shi)管(guan)(guan)(guan)(guan)鋇餐造(zao)影(ying)(ying)檢(jian)查時可(ke)見食(shi)(shi)管(guan)(guan)(guan)(guan)腔(qiang)內(nei)有(you)(you)(you)(you)(you)一(yi)長(chang)條狀(zhuang),香(xiang)腸狀(zhuang)或(huo)(huo)棒狀(zhuang)充盈(ying)缺(que)損陰(yin)影(ying)(ying),表面光滑,下緣(yuan)呈圓形,略有(you)(you)(you)(you)(you)分(fen)葉,陰(yin)影(ying)(ying)(息(xi)(xi)肉)可(ke)隨吞咽動作而在食(shi)(shi)管(guan)(guan)(guan)(guan)腔(qiang)內(nei)上(shang),下移(yi)動,鋇劑在其兩側有(you)(you)(you)(you)(you)分(fen)流現象(xiang);有(you)(you)(you)(you)(you)時鋇劑可(ke)以完全環繞息(xi)(xi)肉,因(yin)此(ci)在食(shi)(shi)管(guan)(guan)(guan)(guan)鋇餐造(zao)影(ying)(ying)檢(jian)查過程中不容易發(fa)現息(xi)(xi)肉在食(shi)(shi)管(guan)(guan)(guan)(guan)壁上(shang)的附(fu)著處(chu)(蒂(di));食(shi)(shi)管(guan)(guan)(guan)(guan)腔(qiang)有(you)(you)(you)(you)(you)不同程度(du)的擴(kuo)張(zhang)(zhang)或(huo)(huo)明(ming)顯擴(kuo)張(zhang)(zhang),但食(shi)(shi)管(guan)(guan)(guan)(guan)擴(kuo)張(zhang)(zhang)的程度(du)往往不均勻(yun),管(guan)(guan)(guan)(guan)壁光滑,食(shi)(shi)管(guan)(guan)(guan)(guan)黏膜皺襞變平坦或(huo)(huo)消失,因(yin)息(xi)(xi)肉堵(du)塞(sai)食(shi)(shi)管(guan)(guan)(guan)(guan)腔(qiang)及(ji)食(shi)(shi)管(guan)(guan)(guan)(guan)腔(qiang)內(nei)有(you)(you)(you)(you)(you)食(shi)(shi)物殘渣(zha)滯(zhi)留,加之(zhi)食(shi)(shi)管(guan)(guan)(guan)(guan)腔(qiang)擴(kuo)張(zhang)(zhang),有(you)(you)(you)(you)(you)時將食(shi)(shi)管(guan)(guan)(guan)(guan)息(xi)(xi)肉誤診(zhen)為賁門(men)失弛緩癥或(huo)(huo)賁門(men)狹窄,甚至(zhi)將食(shi)(shi)管(guan)(guan)(guan)(guan)腔(qiang)內(nei)的腫(zhong)物誤診(zhen)為食(shi)(shi)管(guan)(guan)(guan)(guan)異物,一(yi)旦將食(shi)(shi)管(guan)(guan)(guan)(guan)息(xi)(xi)肉誤診(zhen)為賁門(men)失弛緩癥,有(you)(you)(you)(you)(you)可(ke)能造(zao)成(cheng)嚴重后果(guo)。
2、內鏡檢查
纖維食(shi)管(guan)(guan)鏡(jing)檢(jian)查(cha)對(dui)食(shi)管(guan)(guan)息(xi)肉的診斷具有(you)重要價值。通過此項檢(jian)查(cha),一般能明確診斷,并有(you)可(ke)能發現息(xi)肉蒂的部(bu)位,有(you)助(zhu)于治療,有(you)的病例在做內(nei)鏡(jing)檢(jian)查(cha)時不易(yi)發現息(xi)肉的蒂部(bu),因(yin)食(shi)管(guan)(guan)息(xi)肉在食(shi)管(guan)(guan)腔內(nei)的位置往(wang)(wang)往(wang)(wang)與(yu)食(shi)管(guan)(guan)縱軸(zhou)平(ping)行(xing)(xing),表面為正(zheng)常(chang)的食(shi)管(guan)(guan)黏膜,在息(xi)肉表面咬取(qu)活(huo)體組織進行(xing)(xing)病理檢(jian)查(cha),也往(wang)(wang)往(wang)(wang)報告為正(zheng)常(chang)食(shi)管(guan)(guan)黏膜組織,因(yin)此要加以(yi)注意(yi),以(yi)免延誤(wu)診斷與(yu)治療。
3、其他檢查
有的(de)體積巨大的(de)食管(guan)(guan)息肉病人的(de)X線胸部(bu)正位片上,可以(yi)(yi)看到縱隔陰影增寬(kuan)的(de)征象;食管(guan)(guan)CT掃描(miao)可以(yi)(yi)顯(xian)示食管(guan)(guan)息肉的(de)輪廓、大小(xiao)以(yi)(yi)及與食管(guan)(guan)壁的(de)關系(xi),同時(shi)通過觀察腫(zhong)物(wu)的(de)組織(zhi)密(mi)度,可以(yi)(yi)判斷其性質。