结肠癌侵犯浆膜面的多层螺旋CT表现与淋巴结转移的关系

Relationship between MSCT features and nodal metastasis in colon cancer with serosal invasion

目的探讨结肠癌侵犯浆膜面的多层螺旋CT(MSCT)表现与淋巴结转移的关系。方法收集51例病理证实浆膜面受累的结肠癌患者术前MSCT检查资料,分析MSCT表现与淋巴结转移的情况。结果 MSCT表现为癌肿肠周脂肪间隙清晰6例,脂肪密度增高15例,索条、结节样强化30例,其淋巴结转移率分别为16.7%、40.0%与76.7%,转移度分别为4.2%、11.5%与30.5%,差异均有统计学意义(P<0.05)。淋巴结大小联合癌肿肠周索条、结节样强化判定淋巴结转移的敏感性高于单纯以淋巴结大小为判定标准(P<0.05)。结论癌肿肠周系膜索条、结节样强化的MSCT征象在术前评价结肠癌T3期淋巴结转移有一定参考价值。

Objective To investigate the relationship between multislice computed tomography （MSCT） features and lymph node metastasis in colon cancer with serosal invasion. Methods The preoperative MSCT data of 51 patients with pathologically confirmed colonl cancer with serosal invasion were collected, and MSCT features and nodal metastasis were analyzed. Results MSCT showed clear pericolic fat in 6, high-density pericolic fat in 15, and pericolic cord-like and nodular enhancement in 30 cases. Lymph node metastasis and ratio were 16.7% and 4.2%, 40.0% and 11.5%, and 76.7% and 30.5% for the above 3 MSCT features, respectively, and their differences were significant （P〈0.05）. Lymph node size plus pericolic cord- like and nodular enhancement was more sensitive than lymph node size alone for evaluating nodal metastasis （P〈0.05）. Conclusion The pericolic cord-like and nodular enhancement of MSCT imaging is helpful in the preoperative assessment of nodal metastasis in T3 colon cancer.