64排MSCT检查对结直肠癌术前T分期诊断价值研究

目的旨在探讨64排多层螺旋CT(MSCT)检查对结直肠癌术前T分期诊断价值。方法将2016年1月至2018年12月于陕西省友谊医院和西安交通大学第一附属医院就诊治疗的共86例结直肠癌患者的临床病理及影像学资料进行回顾性整理分析,比较64排MSCT检查对结直肠癌术前分期和术后病理学检查结果一致性。结果 64排MSCT检查对结直肠癌T分期的总诊断准确率为96.51%(83/86),与病理诊断比较无差异(χ^2=3.053,P=0.081);86例结直肠癌患者中,有93.02%(80/86)表现为肠壁增厚,平均厚度为(8.36±1.08)mm,且在肠道增厚患者中以环形或者是不均匀形的环形增厚为主,增厚肠壁表面凹凸不平,进一步增强示动脉期肠交界处增厚管壁呈轻度强化,静脉期及延迟期呈轻度持续强化。其次结直肠癌患者在MSCT可有74.42%(64/86)表现为肠腔狭窄,62.79%(54/86)存在浆膜浸润,而仅有30.23%(26/86)表现为肠旁结节征和20.93%(18/86)表现为肠壁分层。结论 MSCT检查对结直肠癌患者术前T分期诊断率与病理诊断相类似,可作为评估结直肠癌患者T分期的有效手段。

Diagnostic Value of 64-slice MSCT in Preoperative T Staging of Colorectal Cancer

Objective To investigate the diagnostic value of 64-slice MSCT in preoperative T staging of colorectal cancer. Methods The clinical pathology and imaging data of 86 patients with colorectal cancer who were treated in the Friendship Hospital of Shaanxi Province and the First Affiliated Hospital of Xi’an Jiaotong University hospital from January 2016 to December 2018 were retrospectively analyzed. The consistency with postoperative pathological examination in the diagnosis of preoperative staging of colorectal cancer was compared. Results The total diagnostic accuracy of 64-slice MSCT examination for T stage of colorectal cancer was 96.51%(83/86). There was no difference with pathological diagnosis(χ^2=3.053, P=0.081). In the 86 patients with colorectal cancer, 93.02%(80/86) patients showed thickening of the intestinal wall, and the average thickness was(8.36±1.08)mm. In the patients with thickening of the intestinal wall, annular or non-uniform annular thickening was dominant. The surface of the thickened intestinal wall was uneven, and further enhancement showed the thickened wall of the intestine junction in the arterial phase showed mild enhancement, and in the venous phase and delayed phase showed mild continuous enhancement. Secondly, 74.42% patients with colorectal cancer(64/86) showed intestinal stenosis in MSCT, 62.79%(54/86) patients had serosal invasion, and only 30.23%(26/86) patients showed paraintestinal nodules sign and 20.93%(18/86) patients showed stratification of the intestinal wall. Conclusion The diagnostic rate of MSCT for preoperative T staging in patients with colorectal cancer is similar to that of pathological diagnosis. It can be used as the efficient choice to evaluate T staging of patients with colorectal cancer.