多排CT在结肠直肠癌术前诊断应用价值的分析

Value of multi-detector computed tomography for pre-operative staging of colorectal carcinoma

目的:评价多排CT(multi-detector computed tomography,MDCT)在结肠直肠癌术前分期中的应用价值,为临床选择合理的治疗方案提供依据。方法:收集自2010年1月至2012年12月经手术及病理证实且具备完整MDCT影像资料的136例结肠直肠癌患者,以Burton等的分期标准对术前CT影像资料进行分期,并与术后临床TNM分期对照。计算MDCT诊断结肠直肠癌的准确率,分析MDCT术前结肠直肠癌分期与临床术后分期间的一致性。结果:MDCT对结肠直肠癌TNM术前分期诊断的准确率,T分期为77.0%、N分期为71.2%、M分期为99.3%;MDCT对结肠直肠癌的术前分期诊断与术后临床分期一致性较高。结论:MDCT是一种无创、快捷、准确的检查方法,能为结肠直肠癌临床治疗方案的制定提供主要依据,对结肠直肠癌的术前分期诊断具有较高的应用价值。

Objective： To evaluate the diagnostic value of multi-detector computed tomography （MDCT） for pre- operative staging of coloreetal cancer, providing evidences for selecting appropriate treatment regimen. Methods： One hundred and thirty-six patients with surgically and pathologically confirmed coloreetal cancer and comprehensive MDCT imaging from Jan. 2010 to Dec. 2012 were enrolled. Staging of colorectal cancer was assessed pre-operatively by MDCT imaging using the Burton criteria. The accuracy of MDCT for diagnosis of coloreetal cancer was calculated, and the results of preoperative staging by MDCT were matched with the results of staging by surgical/pathological findings. The consistency between preoperative staging by MDCT and post-operative staging by surgical/pathological findings was analyzed. Results： The accuracy of MDCT for staging of TNM staged colorectal cancer was 77.0% for T staging, 71.2% for N staging, and 99.3% for M staging. The consistency between pre-operative staging by MDCT and post-operative staging by surgical/pathological findings was high. Conclusions： MDCT is a noninvasive, convenient and accurate method for diagnosing and pre-operative staging of colorectal cancer, and can provide evidences for formulating an appropriate treatment regimen.