MSCT三期扫描在直肠癌术前TNM 分期诊断价值

目的:评价16层螺旋CT平扫及三期增强扫描对直肠癌术前诊断及TNM分期的诊断价值。方法:回顾性分析75例经病理证实的直肠癌，男性43例，女性32例，平均年龄57岁。所有患者术前采用16层螺旋CT平扫及三期增强扫描，所得数据行薄层及三维重组，对直肠肿瘤进行术前TNM分期，并与病理结果进行对照分析。结果:16层螺旋CT对直肠癌T 分期判定的准确率为83% ，对直肠癌N 分期判定的准确率为76% ，16层螺旋CT判断淋巴结转移的敏感性、特异性、阳性预测值及阴性预测值分别为62% 、87% 、73% 、80% 。16层螺旋CT判断肿瘤浆膜面浸润的敏感性、特异性、阳性预测值及阴性预测值分别为85% 、55% 、84% 、58%。结论:16层螺旋CT平扫及三期增强扫描对直肠癌的术前TNM分期与病理分期有较好的一致性，具有重要的临床价值。 

The Diagnostic Value of Preoperative Staging of Rectal Carcinoma by MSCT Triple-Phase Scanning

Objective: To evaluate the virtues of preoperative 16-slice spiral CT scanning and triple-phase scanning in the diagnosis and staging of rectal carcinoma. Methods:Seventy-five rectal carcinoma tissue samples were collected from 32women and43men, with average age being57years. Sixteen-slice spiral CT scanning and enhanced CT scanning were performed on these patients. The preoperative CT staging results of the75patients with rectal carcinomas were com-pared with pathological examination. Results: Sixteen-slice spiral CT accuracy in T-staging and N-staging of rectal carcino-ma were 83% and 76%, respectively. For lymph node metastases, the sensitivity, specificity, positive predictive value and negative predictive value in 16-slice spiral CT were found to be 62%,87%,73%, and80%, respectively. For serosal inva-sion, the sensitivity, specificity, positive predictive value and negative predictive value in 16-slice spiral CT were found to be 85%,55%,84%, and58%, respectively. Conclusion:The 16-spiral CT scanning and MSCT Triple-phase scanning are valu -ble for preoperative staging of rectal carcinoma.