多层螺旋CT在诊断直肠癌中的临床价值研究

Clinical Value of Multi-slice Spiral CT in the Diagnosis of Rectal Cancer

目的探析多层螺旋CT在直肠癌临床诊断中的应用价值。方法选择我院消化科、肛肠外科2011年5月-2015年11月所收治直肠癌患者54例进行回顾性分析,均应用飞利浦Brilliance CT 64 Slice进行检查,明确患者T分期、N分期及M分期结果并与术后病理结果进行对照。结果直肠癌的螺旋CT主要表现为局限性软组织密度肿块,直肠-乙状结肠壁增厚(呈环形或半环形),向腔内突出生长,密度均匀,肿瘤体积大时可见低密度缺血坏死区。注射造影剂后肿块CT值升高30%左右。以病理结果为基准,16层螺旋CT的T分期诊断符合率为88.9%(48/54),N分期诊断符合率为66.7%(36/54),M分期诊断符合率为96.3%(52/54)。结论多层螺旋CT在直肠癌术前诊断及分期中为应用具有较高的T分期及M分期诊断符合率,可对患者肿瘤病变情况及病灶结构进行良好显示,为直肠癌的可靠检查手段,利于患者临床治疗方案的制定。

Objective To explore the application value of multi-slice spiral CT in the clinical diagnosis of rectal cancer. Methods 54 cases of patients with rectal cancer who were admitted into our hospital between May 2011 and November 2015 were retrospectively analyzed. All patients were examined by Philips CT. The results ofT stage, N stage and M stage were determined and compared with the postoperative pathological results. Results The main spiral CT findings of rectal cancer were localized soft tissue mass, rectum - sigmoid colon wall thickening （circular or semi-circular）, exserted growth into the cavity, with homogeneous density and low-density ischemic necrosis area when tumor was large. After injection of contrast agent, CT value increased by about 30%. Based on pathological results, the diagnostic accuracy of 16 slice spiral CT in T stage, N stage and M stage were 88.9% （48/54）, 66.7% （36/54） and 96.3% （52/54） respectively. Conclusion Multi-slice spiral CT has relatively higher coincidence rate in the diagnosis of rectal cancer in T stage and M stage. It can well display tumor lesions and the structure of lesions. It is a reliable examination method of rectal cancer, and is conducive to the development of clinical treatment regimen for patients.