64层螺旋CT在结肠癌术前分期中的临床价值

Clinical value of the 64-slice spiral CT in preoperative staging of colon cancer

目的评价64层螺旋CT(MSCT)在结肠癌诊断及术前分期中的准确性和应用价值。方法对41例经手术病理证实的结肠癌患者,回顾性分析CT影像在肿瘤侵犯范围、淋巴结转移以及远处转移等特点,并与手术及术后病理对照,分析64层螺旋CT对结肠癌诊断与术前分期的准确性。结果 64层螺旋CT定位诊断准确率为92.7%(38/41),肿瘤侵犯肠管范围准确率达90.2%(37/41)。T分期敏感度为97.6%(40/41),阳性诊断准确率为87.8%(36/41)。N分期敏感度为72.2%(13/18),阳性诊断准确率为66.7%(12/18)。M分期诊断准确率为100.0%。结论64层螺旋CT能准确显示结肠癌的解剖部位、大小和形态,确定肿瘤的侵犯范围、淋巴结转移和远处转移等,更准确地诊断结肠癌和术前分期评估。淋巴结转移的评估是N分期的难点,应结合其大小、形态、密度及其生物学行为进行综合判断。

Objective To assess the accuracy and application value of the 64-slice spiral CT（MSCT） in colon cancer diagnosis and preoperative staging.Methods 41 patients of colon cancer who were confirmed by postoperative pathological results,retrospectively analyze the characteristics of the CT images in tumor invasion scope,lymph node metastasis and distant metastases,investigate the accuracy of the 64-slice spiral CT in colon cancer diagnosis and preoperative staging.Results The 64-slice spiral CT positioning diagnostic accuracy rate was 92.7%（38/41）,tumor invasion intestinal tube scope accuracy rate was 90.2%（37/41）.The sensitivity of T staging was 97.6%（40/41）,the positive diagnosis accuracy rate was 87.8%（36/41）.The sensitivity of N staging was 72.2%（13/18）,the positive diagnosis accuracy rate was 66.7%（12/18）.The sensitivity of M staging was 100%.Conclusion The 64-slice spiral CT can accurately show the anatomical position,size and morphology of the colon cancer,define the scope of tumor invasion,lymph node metastasis and distant metastases,etc,improve the degree of accuracy diagnosis and preoperative evaluation in colon cancer staging.To assess the lymph node metastasis is the difficulty of N staging,we should combine with its size,shape,density and its biological behavior make comprehensive judgments.