[Advanced carcinoma of the thoracic esophagus: CT, MR, and echo-endoscopy in the staging after chemotherapy].

Thirteen patients affected with advanced epidermoid carcinoma of the thoracic esophagus were examined by means of CT, MR and endoscopic US (EUS) before and after chemotherapy. Eleven patients underwent esophagectomy and esophagogastroplasty. An intraesophageal prosthesis was positioned in 2 patients since chemotherapy had not modified tumour stage. Post-chemotherapy CT, MR and EUS parameters were compared with the corresponding pathologic findings. As for MR imaging, post-chemotherapy signal intensity variations in T1 and T2 sequences were also evaluated. MR imaging was more accurate than CT in depicting the involvement of mediastinal fatty layers, the relationships between mass and cardiovascular structures, and the cellularity. CT and MR exhibited limitations in identifying metastatic mediastinal lymph nodes, in which case EUS proved to be the most accurate technique. Both CT and MR failed to satisfactorily assess the infiltration of tracheobronchial tree, which was best demonstrated by endoscopy.