螺旋CT及其后处理技术在直肠癌临床诊断中的价值

The Diagnostic Value of Spiral CT and Its Post Processing Techniques in Rectal Cancer

目的探讨螺旋CT及其图像后处理技术对直肠癌的诊断价值。方法选取49例直肠癌患者,均行螺旋CT扫描,图像传输至工作站进行仿真内镜(VE)、多平面重建(MPR)、表面遮盖显示(SSD)和透明法(Raysum)重建,并与结肠镜和手术病理结果对照。结果 CT检查结果显示:49例患者中,肠壁不规则增厚者49例,腔内肿块者43例,肠腔狭窄者36例,浸润至浆膜者39例;病变向心性狭窄27例,偏心性狭窄22例;大体形态:溃疡型10例,浸润型4例,肿块型22例,混合型13例。与手术病理结果比较,MPR、CT仿真结肠镜(CTVE)、Raysum、SSD显示肿块浸润环肠周程度的符合率分别为95.9%、81.6%、71.4%和59.2%;Raysum、SSD、MPR、CTVE、电子结肠镜(EC)显示癌肿长度的符合率依次为100.0%、93.9%、77.6%、65.3%和55.1%;EC、CTVE、MPR、SSD、Ray-sum显示病理分型的符合率依次为100.0%、93.9%、83.7%、59.2%和59.2%。CTVE结合MPR、SSD和Raysum技术能对直肠癌病变准确定位,并有利于观察肿瘤的形态及特征。结论螺旋CT是一种无创、快捷、安全、准确的检查方法,对直肠癌的诊断具有很高的应用价值。

Objective To investigate the diagnostic value of spiral CT and its post processing techniques in rectal cancer.Methods CT scanning was performed among 49 patients with rectal cancer.Multi-mode image reconstructions including virtual endoscopy（VE）,multi-planar reformation（MPR）,shaded surface display（SSD） and Raysum were performed in the images post processing work station.The image data were compared with the results of colonoscopy and pathology.Results Among these 49 cases,49 had abnormal thickening of rectal walls,43 had intraluminal mass,36 had enterostenosis,39 had invaded serosa,27 had concentric stenosis,and 22 had eccentric stenosis.Gross morphology：ulcerative type in 10 cases,infiltrative type in 4 cases,mass type in 22 cases and mixed type in 13 cases.Compared with the results of pathology,MPR,CTVE,Raysum and SSD showed coincidence rate of circumferential extension were 95.95%,81.6%,71.4% and 59.2% respectively.Raysum,SSD,MPR,CTVE and EC showed coincidence rate of length of cancers were 100.0%,93.9%,77.6%,65.3% and 55.1% respectively.The coincidence rate of pathological type for EC,CTVE,MPR,SSD and Raysum were 100.0%,93.9%,83.7%,59.2%,and 59.2%,respectively.CTVE,MPR,SSD and Raysum could accurately locate the masses,and help to observe the shape and character of masses.Conclusion Spiral CT is a non-invasive,feasible,safe and accurate method for detecting rectal cancer,and plays an very helpful role in the clinical practice.