模拟摇篮体位结肠灌注螺旋CT在大肠癌术前分期的价值研究

The Valuable research of cradle posture colon affusion spiral CT in preoperative staging of colon cancer

目的评价模拟摇篮体位结肠灌注螺旋CT在大肠癌术前分期与病理对照研究的价值。方法 100例大肠癌患者根据不同部位设计不同的模拟摇篮体位,检查前10～15分钟肌肉注射654-210～20mg,自肛门注入500～1200ml的温水。增强扫描层厚为5mm,螺距1～1.5。根据肿瘤的原发部位和淋巴结及远处转移情况,扫描图像及三维重组图像行CT分期并与术后病理分期对照。结果模拟摇篮体位螺旋CT对大肠癌对T1、T2、T3和T4分期的准确性分别为71.4%(5/7)、88%(22/25)、96%(48/50)和100%(18/18),T分期的准确性与大肠癌的进展情况呈正相关。送检156个淋巴结中,CT检出134个,其敏感性85.9%。病理确诊淋巴结转移112个中,CT诊断转移98例,其特异性为87.5%。44例淋巴结转移中,N1分期准确性87.1%(27/31),N2准确性84.6%(11/13)。结论模拟摇篮体位结肠灌注螺旋CT扫描技术能够在术前对大肠癌进行较确切的分期,为临床治疗提供有价值的信息。

Objective To explore the research value of cradle posture spiral colon affusion CT in preoperative staging and pathology comparison of colon cancer.Methods For 100 colon cancer patients,according to different locations,design different cradle postures.10-15 minutes before examination,perform muscle injection 654-2,10-20mg and inject 500-1200ml warm water from anus.The thickness of enhanced scan layer was 5mm and screw pitch was 1-1.5.According to the primary position of tumor and lymph node and distant metastasis,perform CT staging and postoperative pathology stage-comparison of scanning images and three-dimensional rearranged images.Results The accuracy of cradle posture spiral CT to T1,T2,T3 and T4 stages of colon cancer were 71.4%（5/7）,88%（22/25）,96%（48/50） and 100%（18/18）.The accuracy of T staging and the progression of colon cancer were positive correlated.Inspection 156 lymph nodes,CT detected 134,the sensitivity 85.9%.Pathology confirmed transfer 112,diagnostic CT lymph node metastasis,98 cases with its specificity 87.5% for.The accuracy of N1 stage was 87.1%（27/31） and N2 stage was 84.6%（11/13）.Conclusions Cradle posture colon affusion spiral CT scan technology can make accurate staging of colon cancer preoperatively and can provide valuable information for clinical treatment.