多层螺旋CT肠腔充气扫描及图像重建技术对大肠癌的诊断价值

目的 评价多层螺旋CT(MSCT)肠腔充气扫描及图像重建技术对大肠癌的诊断价值.方法 采用16层螺旋CT,对206例临床可疑大肠癌患者经肛管肠腔充气后行全腹快速容积扫描,轴位数据传送至工作站,分别行MPR、SSD、Raysum、MIP及CTVE成像.将MSCT诊断结果与手术病理对照,并与超声(US)、肠镜(CC)的检查结果进行比较.结果 经手术病理证实大肠癌192例,MSCT检出189例.MSCT对大肠癌诊断的敏感度、特异度及准确度分别为98.4%、92.8%及98.1%,对肿瘤的大体分型符合率为98.4%.MSCT对大肠癌的定性诊断能力高于US和CC.结论 MSCT肠腔充气扫描安全、快速,综合运用二维及三维成像技术对肿瘤定位、定性诊断准确,可清楚显示肿瘤的形态特征、血供来源、肠周淋巴结等细节征象,为临床制定合理的手术治疗方案提供可靠依据.

Diagnostic value of MSCT pneumocolon and image reconstruction in colorectal carcinoma

OBJECTIVE: To evaluate the diagnostic value of multislice spiral CT (MSCT) pneumocolon and image reconstruction in colorectal carcinomas. METHODS: 206 patients with suspected colorectal cancer underwent whole abdominal fast volume scan using 16-slice spiral CT before they were insufflated with 1000-1500 ml air through the anus. Then the axis data were transferred to workstation for imaging by MPR, SSD, Raysum, MIP and CTVE, respectively. The results of MSCT diagnosis were compared with those of surgical pathology and from some other common adjunctive techniques, such as ultrasonography (US), colonoscopy (CC), and etc. RESULTS: In this group, 192 cases were confirmed to be colorectal cancer by surgical pathology. 189 cases were identified by MSCT. The sensitivity, specificity and accuracy was 98.4%, 92.8% and 98.1%, respectively. The accuracy rate of general tumor classification was 98.4%. These data were compared with those by US and CC, Statistical analysis showed that the qualitative diagnosis of MSCT is more accurate than those of other two examination methods, indicating that it is most valuable clinical detection approach at present. CONCLUSION: MSCT pneumocolon is a superior detecting method as it is safe, quick and accurate. Due to the accuracy in orienting and qualitative diagnosis by comprehensive application of 2D and 3D imaging techniques, it can clearly display the detailed information of tumor in terms of morphological characteristics, blood-supply resources and pericolonic lymph nodes involvement, which provides reliable basis for making rational surgical protocol.