采用16层螺旋CT诊断直肠癌淋巴结转移的初步研究

目的：评价16层螺旋CT扫描对直肠癌淋巴结转移的诊断价值。方法：回顾性分析64例经手术病理证实的直肠癌CT表现,统计直肠肿瘤周围淋巴结肿大情况并与术后病理结果进行对照分析。结果：以3 mm、6 mm、8 mm、10 mm短径为标准,直肠癌淋巴结转移的转移率分别为31%,37%,54%,75%。以6 mm作为诊断标准时,敏感度及准确度分别为95%、47%,阴性似然比为0.2。淋巴结个数≤4枚,转移率为6.25%;4~9枚组,转移率为52.3%;淋巴结10枚组,转移率为29.6%,淋巴结≤4枚组与4~9枚组、≥10枚组之间比较差别有统计学意义（P〈0.05）;浆膜面浸润组淋巴结转移率（40%）明显高于无浆膜面浸润组（11%）（P〈0.05）。结论：CT扫描有助于发现直肠癌癌肿周围肿大的淋巴结,淋巴结短径≥6 mm提示直肠癌淋巴结转移,直肠周围淋巴结数目大于4枚及肿瘤浆膜层浸润转移率明显提高。

Preliminary Study of the Diagnosis of Lymph Node Metastasis of Rectal Carcinoma by 16-slice Spiral CT

Objective:To evaluate the value of 16-slice CT in the diagnosis of lymph node metastasis of rectal carcinoma.Methods:The CT findings of 64 cases with surgery and pathology proved rectal cancer were retrospectively analyzed,the peri-tumoral lymphadenopathy revealed on CT were counted and correlated with pathologic findings.Results:Taking the short dimension of lymph node assessed on CT as 3mm,6mm,8mm,10mm as diagnosis criteria,the lymph metastases rate was 31%,37%,54%,75% respectively.Taking the short dimens...