多层螺旋CT在进展期大肠癌诊断及治疗中的应用

Application of multi-slice spiral CT in advanced carcinoma of large intestine

目的:探讨多层螺旋CT(MSCT)在进展期大肠癌诊断及治疗中的应用价值。方法:选自经手术治疗的进展期大肠癌患者165例,所有病例术前均行16层螺旋CT和纤维大肠镜检查。其中42例经新辅助化疗后再次行16层螺旋CT检查并行手术治疗。阅CT图像,诊断病变的Borrmann类型、T-分期,判定新辅助化疗疗效,并与术后病理对照。结果:应用MSCT判定进展期大肠癌Borrmann分型的准确率为95.8%(P<0.01);判定T-分期的准确率为82.4%(P<0.05);判定新辅助化疗疗效准确率为88.1%(P<0.05)。结论:MSCT影像因反映了进展期大肠癌的生物学行为,而与病理所见具有一致性。MSCT在诊断进展期大肠癌的Borrmann类型、T-分期、新辅助化疗疗效上具有明显的价值。

Objective：To investigate the application of multi-slice spiral CT in diagnosing advanced carcinoma of large intestine and appraising its curative effect.Methods：Total of 165 patients with advanced carcinoma of colon or rectum were examined with 16-slice spiral CT and colonofibroscope before operations.Among them,42 patients also were examined with 16-slice spiral CT again after a course of neoadjuvant chemothearapy.Then all the patients accepted operations.The CT results of judging Borrmann typing,T-stage and chemical treatment effect were compared with surgical and pathological findings.Results：In diagnosing advanced carcinoma of large intestine by multi-slice spiral CT,the accuracy of judging Borrmann typing was 95.8%（P〈0.01）;the accuracy of judging T-[HK]stage was 82.4%（P〈0.05）;the accuracy of judging neoadjuvant chemotherapy effect was 88.1%（P〈0.05）.Conclusion：Some CT findings reflecting biological behavior of advanced carcinoma of large intestine were correlative to its pathological findings.multi-slice spiral CT is valuable in detecting advanced carcinoma of large intestine with Borrmann typing,T-stage and chemical treatment effect and also valuable to surgical intervention and treatment planning.