低张水灌肠64层螺旋CT对早中期直肠癌诊断和分期的价值

目的探讨低张水灌肠64层螺旋CT在早、中期直肠癌诊断及分期中的临床应用价值。方法回顾性分析2008年1月至2009年12月经手术病理证实的41例早、中期直肠癌患者的CT表现,其中男23例,女18例,与术后病理结果进行对照,分析CT诊断及分期与病理对照的符合率,评价低张水灌肠螺旋CT检查的临床应用价值。结果低张水灌肠64层螺旋CT扫描对41例早、中期直肠癌患者的诊断准确率为92.68%。诊断直肠癌侵犯浆膜外脂肪的敏感度、特异度、假阳性、假阴性分别为66.67%、76.47%、23.53%、33.33%。CT分期和病理分期为DukesA及B期的符合率分别为78.57%、66.67%,总符合率为71.05%。结论低张水灌肠64层螺旋CT检查对于早、中期直肠癌的诊断和浆膜外脂肪侵犯的检出有重要价值,是早、中期直肠癌检查中的一种重要的影像检查手段。

Value of diagnosis and staging on early-middle rectal carcinomas by 64-slice spiral CT with hypotonic water enema

Objective To explore the diagnosis and staging of early-middle stage rectal carcinomas by 64-slice spiral CT with hypotonic water enema.Methods Forty one（male =23,female =18） patients proved by surgical pathology retrospectively were reviewed to calculate the coincidence of diagnosis and stagement by 64-slice spiral CT with hypotonic water enema.Results The diagnosis accuracy in the group of 64-slice spiral CT with hypotonic water enema was 92.68%.The sensitivity,specificity,false positive and false negative rates of diagnosing the fat invasion outside the plasma membrane by CT was 66.67%,76.47%,23.53%,33.33% respectively.The coincidence between CT and pathology for Dukes A,B was 78.57% and 66.67% respectively,and the whole coincidence was 71.05%.Conclusions 64-slice spiral CT with hypotonic water enema is useful to diagnose and stage the rectal carcinoma in early-middle stage.