多层螺旋CT低张充气增强扫描在结肠癌诊断及术前分期中的应用价值

Application Value of MSCT Hypotonic Enhanced Scanning in Diagnosis and Pre-Operative Staging of Colorectal Cancers

目的探讨多层螺旋CT（MSCT）低张充气增强扫描在结肠癌诊断及术前分期中的应用价值。方法筛选2013年1月-2014年12月我院收治的116例结肠癌患者作为研究对象。所有患者均行MSCT平扫及低张充气增强扫描,采用多平面重建技术处理图像,观察结肠壁厚度、肿瘤长度、CT值等指标,并进行诊断及术前病理分型、分期,且与术后病理结果进行比较。结果 MSCT术前T分期结果与术后病理结果比较无显著差异,不同病理分期的肿瘤长度及不同病理分型的肿瘤CT值存在显著差异,但不同病理分期的肿瘤CT值比较无显著差异。MSCT确诊结肠癌105例,与病理结果无显著差异（P〈0.01）。结论对结肠癌患者采用MSCT低张充气增强扫描可实现最小化医源性创伤,且临床确诊率较高,术前分期及病理分型较为准确,可有效指导结肠癌治疗方案的选择,具有临床应用及推广价值。

Objective To investigate the application value of MSCT（Multi-Slice Spiral Computerized Tomography） hypotonic enhanced scanning in diagnosis and pre-operative staging of colorectal cancers. Methods Altogether 116 colorectal cancer patients who had been treated from January 2013 to December 2014 in the hospital were selected and scanned by plain MSCT and hypotonic enhanced MSCT. Then, all the images were processed through the multi-planar reconstruction technique to observe the thickness of the colon wall, the length of tumors and the CT value so as to diagnose colorectal cancers and identify the preoperative pathological type and stage. Moreover, comparisons were made between preoperative and postoperative pathological diagnoses. Results No significant differences were seen between the preoperative T-staging results acquired by MSCT and the postoperative pathological results. While, remarkable differences existed between the length of tumors in different pathologic stages and the CT values of different pathological types of tumors. The CT value of tumors in different pathological stages had no significant differences. Among all the cases, 105 patients were identified by MSCT with colorectal cancers, which showed no significant differences from the pathological results（P〈0.01）. ConclusionHypotonic enhanced MSCT demonstrated its advantages of minimum iatrogenic trauma, the higher clinical diagnosis rate and more accurate preoperative staging and pathological classification, which could provide effective guidance for selection of treatment options for colorectal cancer patients and deserve wider clinical application and promotion.