直肠癌的CT检查及价值（附28例病理对照）

CT Scanning of Rectal Carcinoma and its Evaluation

目的：探讨直肠癌术前ＣＴ检查的意义及价值。材料和方法：回顾分析２８例直肠癌患者术前ＣＴ所见和手术病理结果对照，以及术前Ｔｈｏｅｎｉ氏ＣＴ分期和改良Ｄｕｋｅｓ病理分期对照。结果：术前ＣＴ能显示直肠癌的形态、大小、范围和肠壁的厚度。确定直肠周围组织浸润准确率为８２．１％，敏感性９０．９％，特异性７６．５％，确定肠旁淋巴结转移准确率６４．３％，敏感性５０％，特异性９０％；ＣＴ分期准确率为８５．７％。结论：直肠癌术前ＣＴ检查及ＣＴ分期能客观反映直肠癌的病理改变，同时行上腹部甚至全腹部扫描，可明确有无肝脏等远处脏器转移，对直肠癌患者治疗方法的选择有重要意义，提高患者的５年生存率亦有一定价值。

To discuss and evaluate the preoperative CT scanning in rectal carcinomas.Materials and Methods:Author retrospectively analyzed the preoperative CT imagings with surgical pathologic findings, the Thoeni CT staging and the Modified Dukes Classification of 28 patients with rectal carcinoma.Results:The CT scan showed the appearance,size and extent of the rectal tumors and thickness of the rectal wall.The accuracy,sensitivity and specificity of perirectal invasion were 82.1%,90.9% and 76.5% and of perirectal lymph node metastases were 64.3%, 50% and 90% respectively.The accuracy rate of CT staging was 85.7%. Concltision: the preoperative CT scanning and staging showed nearly the pathologic changes of the carcinoma objectively.The scanning extent inclusion of upper abdoman or even the whole abdomen may further provide the detection of metastases in liver or other organs, good for choice of treatment and raise 5-year survival rate.