64排螺旋CT多种重建对直肠癌肠系膜淋巴结的显示

Multiple reconstruction of 64-slice spiral CT for displaying the mesenteric lymph nodes in rectal cancer

目的探讨多层螺旋CT对直肠癌的淋巴结分布和转移规律的显示。方法对28例直肠癌患者的螺旋CT扫描进行常规的三维重建以及调节窗宽窗位至肠窗、曲面重建和容积重建,比较两者对直肠淋巴结的显示数量。结果常规重建观察平均每例患者发现2.09±1.41枚直肠淋巴结,淋巴结的直径在0.6cm以上;经调整肠窗、曲面重建及容积重建后观察,平均每例可发现6.64±2.13枚淋巴结,可发现的淋巴结最小直径可达0.3cm,两者比较所发现的淋巴结数量有显著性差异。结论 64排螺旋CT利用调整窗宽窗位至肠窗、曲面重建及容积重建,可较常规的CT三维重建显示更多的直肠淋巴结,有利于显示直肠癌淋巴结的分布规律。

Objective To investigate multiple reconstruction of 64-slice spiral CT to display the lymph nodes in rectal cancer. Methods Twenty-eight patients with rectal cancer underwent CT scan. Multiple reconstruction had done in all patients.Conventional methods of three-dimensional reconstruction, including observation in axial, sagittal and coronal plane. Additional methods,including to adjust window width and window level to bowel window（window width 300 Hu, window level 0 Hu）, curve reconstruction, and volume reconstruction. The number of lymph nodes were compared between the conventional CT methods and additional methods. Results 2.09±1.41 lymph nodes on average were found in the conventional methods, and the diameters of lymph nodes observed were more than 6 mm. Conversely, 6.64±2.13 lymph nodes on average were found in additional methods, and some lymph nodes of diameter were less than 6 mm.There was significance difference between two reconstruction methods. Conclusion Using bowel window,curve reconstruction, and volume reconstruction could display more lymph nodes than conventional CT methods of three-dimensional reconstruction, and can provide distributive rules of lymph nodes in rectal cancer.