多层螺旋CT仿真内镜与电子肠镜在诊断大肠癌中的对照研究

Comparative Study of Multi-slice Helical CT Virtual Endoscopy with Electronic Colonoscopy in Diagnosis of Colorectal Cancer

目的探讨多层螺旋CT仿真内镜(CTVC)对大肠癌的诊断价值。方法选择21例大肠癌患者,均行多层螺旋CT扫描,图像传输至工作站进行仿真内镜成像,并与电子肠镜检查结果和手术病理结果进行对照。结果21例大肠癌患者中,CTVC检出了全部肿瘤,检出率为100.0%;电子肠镜检出肿瘤19个,检出率为90.5%。CTVC对肿块型大肠癌的判断较电子肠镜准确,两种方法对肿块型大肠癌的分型符合率分别为9/9和8/9;CTVC对浸润型、溃疡型及混合型大肠癌的判断与电子肠镜相当。CTVC对右半结肠癌的定位诊断符合率为100.0%,高于电子肠镜的85.7%,对左半结肠癌的定位诊断符合率(100.0%)与电子肠镜(100.0%)相同。结论多层螺旋CTVC可旋转任意角度及远、近两端分别观察肿瘤的形态特征,并能准确定位及判断肿瘤浸润范围,是一种很有实用价值的检查方法。

Objective To investigate the diagnostic value of multi-slice helical CT virtual conoscopy（CTVC） in colorectal cancer.Methods CTVC was performed in 21 colorectal cancer patients.The imagings were transmitted to workstation to conduct virtual endoscopy and compared with those of surgical pathology.Results In 21 colorectal cancer patients,CTVC detected out all tumors with a detection rate of 100%,higher than electronic colonoscopy （EC,19 tumors,90.5%）.CTVC was more accurate than EC in diagnosis of mass-type colorectal tumors,and the typing coincidence of 2 methods were 9/9,8/9,respectively,but the same in diagnosis of infiltrative,ulcer or mixed types of colorectal cancers.The coincidence of CTVC was 100.0% in positioning diagnosis of right colon cancers,higher than EC （85.7%）,but the same in diagnosis of left colon cancers （both 100.0%）.Conclusion Multi-slice spiral CTVC,which can rotate freely to any angles and both proximal and distal ends to observe the morphological characteristics of tumors and locate and determine the scope of tumor invasion,is a useful screening method of practical value.