结肠癌侵犯横结肠系膜MSCT表现及其解剖学基础

CT features of transverse mesocolon involvement in colonic carcinoma and the anatomic basis

目的探讨结肠癌侵犯横结肠系膜的MSCT表现及其解剖学基础。方法回顾性分析28例经手术病理证实的肝曲结肠、横结肠和脾区结肠癌的CT资料,对横结肠系膜受侵和淋巴结转移情况进行分析,并与手术病理结果对照。结果 28例中,横结肠系膜软组织肿块形成、与癌肿相续的楔形或结节状软组织影、与癌肿相续的索条影和癌肿对应区系膜密度增高判定癌肿侵犯横结肠系膜的敏感性分别为16.7%,61.1%,5.6%,33.3%;特异性分别为100%,80%,30%,50%,准确度分别为46.4%,67.9%,14.3%,39.3%。5例横结肠系膜见增大淋巴结。结论结肠癌侵犯横结肠系膜有一定的CT表现特征,MSCT在术前评价横结肠系膜受侵和淋巴结转移方面具有重要价值。

Objctive To evaluate multiple-slice computed tomographic （MSCT） features of colonic carcinoma involving the transverse mesocolon （TM） and its anatomic basis. Met.hods The MSCT images of 28 cases with colonic carcinoma were compared with surgical and pathological findings, retrospectively. Rcmxlts Among the 28 cases, the sensitivity, specificity and accuracy of judging TM infiltration by mass forming, nodular and wedge-shaped shadow, short bars and increased fat density in the TM were 16.7%, 61.1% ,5.6% ,33.3%; 100% ,80% ,30% ,50%; 46.4% ,67.9%, 14.3 % ,39.3%. Five cases showed enlarged lymph nodes in the TM. Conclusion The involvement of TM by colonic carcinoma can show some special CT features. MSCT images are helpful for preoperative imaging evaluation of TM involvement and lymphatic spread.