螺旋CT结肠造影对大肠癌术前TNM分期的评价

目的 评价螺旋CT结肠造影检查对大肠癌术前TNM分期的方法和诊断价值. 方法 回顾性分析35例大肠癌患者术前螺旋CT结肠造影增强扫描影像资料,进行TNM分期,并与手术所见和术后病理结果进行对照.结果 螺旋CT术前TNM分期总的准确性为71.4%(25/35).判断T分期的准确性为85.7%(30/35),N分期的准确性为74.3%(26/35).评价肿瘤浆膜浸润的敏感性和特异性分别为96.7%(29/30)和60%(3/5).判断淋巴结转移的敏感性和特异性分别为78.9%(15/19)和81.3%(13/16).1例肠系膜转移和2例大网膜转移的患者,螺旋CT均正确诊断. 结论 螺旋CT结肠造影对大肠癌术前分期和选择最佳治疗方案及判断预后具有重要意义,但仍有一定的局限性.

Value of spiral CT colonography in preoperative TNM staging of colorectal carcinoma

Objective To probe method as well as value of spiral CT colonography in preoperative TNM staging for colorectal carcinoma. Methods 35 patients with colorectal carcinoma underwent contrast-enhanced spiral CT colonography (SCST). SCST findings underwent preoperative TNM staging and were compared with opera- tional findings and post-operative pathological findings. Results The overall accuracy of preoperative staging using SCTC was 71.4% (25/35), accuracy for T staging and N staging was 85.7%(30/35) and 74.3%(26/35), respectively. Sensitivity and specificity for local serous invasion was 96.7%(29/30) and 60% (3/5), respectively, and for lym- phatic metastasis was 78.9%(15/19) and 81.3%(13/16) respectively. SCST also correctly detected one case of mesenteric metastasis and two cases of greater omentum metastasis. Conclusion SCTC plays an important role in preoperative staging, selecting suitable treatment and evaluating prognosis for colorectal carcinoma, but it still has limitations.