直肠癌术后局部复发的CT诊断

CT scan in the diagnosis of postoperative local recurrence of rectal carcinoma

目的 探讨直肠癌术后复发的CT诊断。方法 2 3例直肠癌术后局部复发病例 ,其中 40 %伴有远处转移。CT扫描使用PICKERPQ50 0 0螺旋CT扫描机 ,层厚和间隔均为 8mm ,吻合口部位必要时加做层厚和间隔均为3mm的薄层扫描。结果 直肠癌局部复发的主要CT表现有 :吻合口局部肠壁不均匀性增厚 ,局限性管腔偏心性狭窄 ;吻合口处肠腔内不规则软组织肿块影 ;吻合口周围或骶骨前区不规则软组织肿块影 ;肿块周围临近的筋膜、脂肪层受侵 ,结构消失 ;肿块较基础扫描增大 ;膀胱、前列腺、精囊、子宫受侵、推压移位 ;骶骨局限性骨质破坏等。结论 CT是检查直肠癌术后复发的有效手段 ,其对直肠癌术后复发的位置、大小、范围。

Objective To evaluate CT scan in the diagnosis of postoperative recurrence of rectal carcinoma. Methods Of 23 cases of postoperative recurrence of rectal carcinoma, about 40% of them were accompanied with distant metastatic disease. CT scanning of PICKER PQ5000 was performed with 8mm slice thickness and 8mm interval, and at the same time images were obtained with 3mm thick sections at 3mm intervals around the operative anastomotic stoma site.Results The main CT findings of rectal carcinoma postoperative recurrence were as follow: irregular thickened local wall of anastomotic stoma, and eccentric constriction of the local intestinal lumen; irregular soft tissue mass of anastomotic stoma; soft tissue mass around anastomotic stoma and in front of sacral bone; the adjacent organs such as uterus, prostatic gland, urinary bladder and seminal vesicle were involved or expressed; the fascia and fat around rectum were involved, and their formation extincted; destruction of local sacral bone etc.Conclusion CT scan is an effective method in diagnosing the recurrence of rectal carcinoma, and it is good in demonstrating the site, size, extent, extraluminal mass and distant metastasis.