Diagnosis of lymph node metastasis in esophageal carcinoma

To assess the utility of MR imaging in diagnosis of lymph node metastasis, the author studied 70 patients with histologically proved esophageal squamous cell carcinoma. Coronal spin echo imaging (SE 400/40) was the most available method in the mediastinum and using this method, lymph nodes were clearly imaged along trachea and vessels of the mediastinum in its long axis. The 250 lymph nodes from 44 patients who underwent laparotomy, thracotomy and cervical dissection, were reviewed for findings by coronal MRI. Detectability of lymph nodes was 141/250 (56%) in total. Cervical and paraesophageal nodes were unable to detect well, but paratracheal, subcarinal, hilar nodes, supraclavicular nodes which are clinically important region for lymph node dissection of esophageal surgery were well-detected. Distinction between metastatic and non-metastatic nodes was studied on its size and its location. The supraclavicular and paratracheal nodes larger than 1.5 cm in diameter were involved in cancer invasion for the most part. (author)