多层螺旋CT扫描在结直肠癌诊断和术前分期中的应用价值

目的:评价多层螺旋CT扫描(MSCT)在结直肠癌诊断和术前分期中的应用价值。方法:回顾性分析经手术或常规结肠镜活检病理证实的40例结直肠癌的多层螺旋CT表现,并与病理结果对照。结果:病理证实结直肠癌40例(其中盲肠癌6例,升结肠癌3例,横结肠癌3例,降结肠癌5例,乙状结肠癌1例,直肠癌22例),多层螺旋CT检出了全部结直肠癌,敏感性为100%,总的分期准确率为80%(32/40),B期分期准确率为83.3%(15/18),C期分期准确率为66.7%(8/12),肿瘤浆膜外侵犯的敏感性和特异性分别为95%(36/34)和50%(2/4),淋巴结转移的敏感性和特异性分别为60%(12/20)和90%(9/10)。结论:多层螺旋CT扫描(MSCT)可以有效地显示结直肠癌的部位、大小和形态、确定中晚期结直肠癌的侵犯范围、远处转移及淋巴结转移等,从而更准确地诊断并进行术前分期,具有较高的临床应用价值。

Clinical value of multislice spiral CT for the diagnosis and preoperative staging of colorectal carcinoma

Objective:To evaluate the clinical value of multislice spiral CT(MSCT) in the diagnosis and preoperative staging of colorectal carcinoma.Methods:MSCT findings of 40 patients with colorectal carcinoma were restrospectively analyzed and compared with conventional colonoscopy bioptic or surgical histology.Results:In 40 patients with rectum or colon carcinoma proven by pathology,there were 6 cases with cecum carcinomas,3 cases with ascending colon carcinomas,3 cases with transverse colon carcinomas,5 cases with descending colon carcinomas,1 case with-sigmoid colon carcinomas and 22 cases with rectum carcinomas.All lesions were demonstrated clearly by MSCT and the sensitivity was 100%;The overall accuracy rate of staging with the modified Dukes' classification was 80%.The accuracy rate of stage B and stage C were 83.3% and 66.7% respectively.Sensitivity and specificity for serosal infiltration were 95% and 50% respectively.Sensitivity and specificity for lymph node involvement were 60% and 90% respectively.Conclusion:MSCT is a better method of depicting the colorectal carcinoma.It can display the tumor's position,size and shape efficiently and allow accuracy staging of the colorectal carcinoma,especially detecting the invasion of adjacent tissues and distant metastasis.So MSCT is valuable for the clinical diagnosis and preoperative staging of color ectal carcinoma.