左右半结肠黏液腺癌的CT表现比较

Comparison of CT manifestations of left-sided and right-sided colon mucinous adenocarcinoma

目的探讨左、右半结肠黏液腺癌CT表现和位置的关系。方法回顾性分析云南省肿瘤医院收治的168例经病理确诊的结直肠黏液腺癌患者临床和CT资料,按病灶部位分为左、右半结肠黏液腺癌两组,比较两组患者发病年龄、性别、病变肠壁长度及厚度、肠壁增厚形式、平扫CT值、增强CT值、强化程度、增强后低密度区比例、肠周浸润程度、肠周淋巴结转移、远处转移的差异。结果左、右半结肠黏液腺癌两组在病变肠壁长度及厚度(t=5.066、3.903,P<0.05)、肠壁增厚形式(χ~2=15.398,P<0.05)、肠周浸润程度(χ~2=9.954,P=0.007)、强化程度(χ~2=9.641,P=0.008)、增强后低密度区比例(χ~2=12.946,P=0.002)等方面差异有统计学意义,在平均发病年龄、平扫CT值、增强CT值、性别比例、淋巴结转移、远处转移等方面差异无统计学意义(t=0.029、0.0108、1.494,χ~2=0.148、0.391、0.910,P>0.05)。结论左、右半结肠黏液腺癌的CT表现差异有显著统计学意义。相对左半结肠黏液腺癌,右半结肠黏液腺癌病变肠壁范围更广、厚度更大、肠周浸润程度更重,CT增强后强化程度较低且低密度区比例更高。

Objective To compare the difference of CT manifestations of left-sided and right-sidedcolon mucinous adenocarcinoma,and to improve the radiology acknowledge about them.Methods CT findingsof168patients with colorectal mucinous adenocarcinoma confirmed by surgery and pathology were retrospectivelyanalyzed in the Tumor Hospital of Yunnan Province,the differences of age,gender,length and thickness of theinvolved intestinal wall,the thickening pattern of the intestinal wall,the peri-intestinal invasion,CT value on NECT,CT value on CECT,the contrast-enhanced form,degree of low density region in CECT,the occurrence metastasisof lymph node and other organs were compared between the two groups.Results Compared with the left-sidedcolon mucinous adenocarcinoma group,lesions of right-sided colon mucinous adenocarcinoma group was widerand thicker(t=5.066、3.903,P<0.05).There were statistically significant differences of the thickening patternof the intestinal wall(χ2=15.398,P<0.05),peri-intestinal invasion(χ2=9.954,P=0.007),contrast-enhanced level(χ2=9.641,P=0.008)and low density region in enhanced CT show(χ2=12.946,P=0.002)between the two groups,while there was no statistically significant difference in age,CT value on NECT,CT value on CECT,gender,lymphnode metastasis and other organs metastasis(t=0.029、0.0108、1.494,χ2=0.148、0.391、0.910,P>0.05).Conclusion There are some differences of CT manifestations of left-sided and right-sided colon mucinousadenocarcinoma.Compared with left-sided colon mucinous adenocarcinoma,the CT manifestations of right-sidedcolon mucinous adenocarcinoma include a wider and thicker of bowel wall thickening with the lower enhancementdegree and more cystic components in contrast-enhanced CT show.