三维CT与结肠镜在结、直肠癌中的应用价值比较

Comparative study of multi-slice CT with electronic colonoscopy in the diagnosis of colorectal carcinoma

目的:比较三维多层螺旋CT(MSCT)与结肠镜诊断结、直肠癌的临床价值。材料与方法:对261例结、直肠癌患者进行纤维结肠镜及全腹容积扫描,在工作站分别行多平面重建(MPR)、表面遮盖显示(SSD)、仿真内窥镜(CTVE)等多种重建成像,观察癌肿、局部浸润、淋巴结及远处转移的情况,并与结肠镜及手术病理对照。结果:MSCT能准确地显示肿瘤的大体分型与发生部位,诊断符合率为100%,并且可获得管腔外病变信息。结肠镜显示肿瘤直观、并可获得病理资料,但在肿瘤定位方面存在不足。结论:结肠三维CT快捷、安全、准确,对结、直肠癌的诊断具有很高的应用价值。与纤维结肠镜联合应用,可以全面客观地指导医生选择科学的手术方法,应该成为术前的常规检查项目。

Objective： To compare the value of multi-slice CT（MSCT） with electronic colonoscopy in the diagnosis of colorectal carcinoma. Methods： Two hundred and sixty-one patients with colorectal cancer underwent whole abdominal volume scanning using 16-slice spiral CT. Multimode image reconstructions including multiplanar reformation（MPR）, shaded surface display（SSD）, and CT virtual endoscopy（CTVE） were performed. CT results of local invasion and metastases of lymph nodes were compared with endoscopy, surgical and pathological findings. CT can also get information out of colon. Results： MSCT could accurately show the general classification of tumor and position, the diagnostic accurate rate was 100%. Colonoscopy can show tumor directly and acquire pathological material. But it was inadequate for the location of the lesion. Conclusion： MSCT is of significant value as a convenient, safe and accurate method in diagnosing colorectal carcinoma. The association of 3D-CT and colonoscopy can help surgeon to choose rational operative program objectively, so it should be the routine examination before operation.