摇篮体位技术在结肠癌术前CT分期的价值

Value of cradle position technology in preoperative CT staging of colorectal carcinoma

为了评价摇篮体位技术结肠灌注CT扫描在结肠癌术前分期的价值,将130例结肠癌患者根据病变部位采取不同的摇篮体位,检查前低张肠道自肛门注入800～1 200mL的温水,增强CT扫描。右半结肠肿瘤取右侧卧位,左半结肠取左侧卧位。根据肿瘤的浸润程度和淋巴结情况进行CT分期,并与术后病理分期对照。术前CT分期T1低估3例,T2分别高估1例和低估4例,T3高估3例和低估3例,T4高估1例。T1分期准确率76.9%(10/13),T2准确率85.7%(30/35),T3准确率90.6%(58/64),T4准确率94.4%(17/18)。切除送检910个淋巴结中,CT检出581个,敏感性63.8%。送检淋巴结中确诊转移390个,CT诊断转移341例,特异性为87.4%。初步研究结果提示,摇篮体位技术结肠灌注CT扫描能够对结肠癌进行术前准确分期,为临床决策治疗提供有价值的信息。

The objective of this study was to evaluate the value of Cradle position colon perfusion CT scan technology in preoperative staging of colorectal carcinoma.One hundred and thirty colon cancer patients,according to different lesion sites,took different cradle postures and was injected 800 to 1 200 mL warm water from anus before scanning Intensive CT.Right-sided colonic carcinoma patients took the right recumbent position,and the left took the left recumbent position.On the basis of the invasion degree of tumor and lymph nodes,CT staging was performed and then compared with postoperative pathologic stage.Three cases with T1 tumor were underestimated,1 case of T2 tumor was overvalued and 4 undervalued,3 cases of T3 tumor was overestimated and other 3 underestimated and 1 case of T4 tumor was overvalued by preoperative CT.The accuracy rates of T1,T2,T3 and T4 stages were 76.9%（10/13）,85.7%（30/35）,90.6%（58/64） and 94.4%（17/18）,respectively.Five hundred and eighty-one lymph nodes of 910 were detected by CT and the sensitivity was 63.8%.three hundred and ninety of 910 were confirmed positive,341 of 390 were Diagnosis by CT and the specificity was 87.4%.In conclusion,Cradle position colon affusion CT scan technology can make preoperative accurate staging of colon cancer and provide valuable information for clinical management of patients.