CT诊断术前结肠癌以及术后结肠癌复发的临床价值

Clinical Value of CT in Diagnosis of Preoperative Colorectal Cancer and Postoperative Colorectal Cancer Relapse

目的研究探讨应用多排螺旋CT诊断术前结肠癌及术后结肠癌复发的临床应用价值。方法随机选取该院2014年3月—2015年3月间收治的经结肠镜或者手术病理诊断证实结肠癌及结肠癌复发患者50例作为研究对象,回顾性患者的临床基本资料及其经多排螺旋CT扫描获得的影像学资料,对其进行术前病理分期和术后复发监测,了解患者的影像学特征,并与手术病理诊断结果进行对照,计算CT的检出率。结果 33例结肠癌患者经术前CT扫描,TNMⅠ期、Ⅱ期、Ⅲ期、Ⅳ期患者各9例、15例、6例和3例的诊断符合率分别为88.9%、86.7%、100.0%、100.0%。17例结肠癌复发的患者经CT扫描,TNMⅠ期、Ⅱ期、Ⅲ期、Ⅳ期患者的诊断符合率分别为50.0%、66.7%、100.0%、100.0%,均可见TNMⅢ、Ⅳ期患者的CT诊断符合率高于TNMⅠ、Ⅱ期,比较均差异有统计学意义(P<0.05)。结论通过多排CT扫描可以为结肠癌的术前分期提供依据,有效监测术后复发情况,操作简便,图像清晰直观,对指导临床治疗具有重要意义,值得临床推广应用。

Objective To research and discuss the clinical application value of multi-slice spiral CT in diagnosis of preoperative colorectal cancer and postoperative colorectal cancer relapse. Methods 50 cases of patients with colorectal cancer or colorectal cancer relapse confirmed by colonoscope and surgical pathology admitted and treated in our hospital from March2014 to March 2015 were selected as the research object, the clinical basic data and imaging data obtained by multi-slice spiral CT scan of the patients were retrospectively analyzed, and they were given preoperative pathological staging and postoperative relapse monitoring, the patient＇s imaging characteristics were known and then comparing them with surgical pathology diagnostic results, the detection rate of CT was calculated. Results In 33 cases with colorectal cancer after preoperative CT scan, TNM Ⅰstage, Ⅱstage, Ⅲstage, Ⅳstage occurred to 9 cases, 15 cases, 6 cases and 3 cases, and the diagnostic accordance rate was respectively 88.9%, 86.7%, 100.0% and 100.0%, in 17 cases with colorectal cancer relapse,the diagnostic rate of patients in TNM Ⅰstage, Ⅱstage, Ⅲstage and Ⅳstage was respectively 50.0%, 66.7%, 100.0% and100.0%, the diagnostic accordance rate of CT in patients in TNM Ⅲ and Ⅳ stages was higher than that in patients in TNMⅠand Ⅱ stages, and the comparisons were statistically significant（P0.05）. Conclusion Multi-slice spiral CT scan can provide basis for the preoperative staging of colorectal cancer and effectively monitor postoperative relapse with easy operation and clear and intuitive images, and it is of important significance to guide the clinical treatment and is worth clinical promotion and application.