CT结肠造影评价结直肠癌:技术特征的描述与比较

CT colonography for evaluation of colorectal cancer

目的:通过对计算机断层扫描结肠造影(computed tomography colonography,CTC)与结肠镜评价结直肠癌的显示技术进行描述与对比,评价CTC技术可行性.方法:本研究共入选经结肠镜活检诊断为结直肠癌的患者41例(25男,16女,中位年龄65岁,范围47-72岁),进行CTC检查,评价并比较CTC与结肠镜的显示技术(肠道准备情况、肿瘤位置、大小、形态学特征及临床TNM分期),统计学处理采用描述性分析,P<0.05为差异具有统计学意义.结果:CTC与结肠镜评价肿瘤位置一致.结肠镜判断肿瘤大小具有局限性,本研究中只能对54%(23/43)的肿瘤进行大小测量,而CTC可测量95%(41/43)的肿瘤.肿瘤大体病理类型显示情况差异无统计学意义(P=0.621).结肠镜不能评价肠腔外情况及梗阻近侧结肠,造成不完全检查.结肠镜主观耐受性评分低于CTC(P=0.000).结论:CTC可以有效评价结直肠癌,但不能完全代替结肠镜,CTC可作为不耐受结肠镜检查、结肠镜不完全检查患者的首选工具.

AIM： To evaluate the value of computed tomography colonography（CTC） in the evaluation of colorectal cancer by comparing its performance with colonoscopy. METHODS： Forty-one patients who were diagnosed with colorectal cancer by colonoscopic biopsy and underwent CTC and colonoscopy were included in the study. CTC and colonoscopy were compared for their performance in the evaluation of colorectal cancer. RESULTS： The locations of tumors revealed by CTC and colonoscopy were consistent. However, colonoscopy had its limitation in determining the size of the tumor, and tumor size was measured by colonoscopy in 54%（23/43） of cases, in contrast to 95%（41/43） of cases by CTC. There was no statistical significance in the pathological type revealed by the two techniques（P = 0.621）. Colonoscopy failed to evaluate the condition outside the intestinal tract and the proximal colon in cases with colon obstruction, resulting in incomplete examination. The grade of subjective tolerability was significantly lower for colonoscopy than for CTC（P = 0.000）. CONCLUSION： CTC can evaluate colorectal cancer effectively, although it cannot replace colonoscopy entirely. CTC can be chosen as a preferred means for patients who cannot tolerate colonoscopy as well as patients who have incomplete colonoscopy examination.