多层螺旋CT及双期增强扫描对大肠癌术前分期价值研究

The value of MSCT and enhanced scan in preoperative staging of colonic tumors

目的评价大肠低张充气多层螺旋CT结肠重建成像（multi-slice spiral CT of colon MSCTC），及双期增强扫描在大肠癌术前分期中的应用价值。方法研究35例经纤维内镜检查证实或临床高度怀疑大肠癌患者进行MSCTC及双期动态增强扫描检查。利用MSCTC后处理图像，并结合各期横断面图像，观察肿瘤原发病灶、淋巴结和远处转移情况进行分期（TNM分期），并与手术病理结果对照。结果本组多层螺旋CT研究显示对大肠癌T期敏感性100％（35／35），T期的准确率91．5％（32／35）。N期的敏感性80．0％（16／20），N期准确率75．0％（15／20）。4例肝脏转移经CT检出。结论大肠癌术前MSCTC成像及结合各期横断面图像，能进行准确术前分期，并为临床提供立体准确的影像学信息。

Objective To evaluate the accuracy of multi-slice CT pneumocolon in the staging of colonic carcinomas. Methods Thirty-five patients who were strongly suspected to have colonic disorders underwent CT pneumocolon before and after intravenous injection of iodinated contrast agent. Raysum images were then obtained by using MSCTC sofiwares in workstation. The positive cases were preoperatively staged according to TNM standard. All cases were proved by surgical or colonoscopic histology. Results Sensitivity and positive accuracy value for T staging were 100% （35/35） and 91.5% （32/35）, respectively. Sensitivity and positive accuracy value for N staging were 80.0% （16/20） and 75.0% （15/20）, respectively. Conclusions Transverse images in different stage combined with the images obtained by using MSCTC might allow accurate staging of the colonic carcinomas.