结直肠癌肝转移瘤的CT成像特点及规律分析

CT imaging features and regularity analysis of colorectal cancer liver metastases

目的探讨结直肠癌肝转移瘤的CT成像特点及规律分析。方法回顾性分析我院2016年3月—2018年3月的84例结直肠癌肝转移瘤患者的CT动态增强图像及临床资料记录并统计其不同血流汇入情况下、不同增强时期的CT成像结果,根据原发灶部位,将患者分为左半结肠组和右半结肠组,左半结肠组再按照血管重建情况分组。结果原发灶在左半结肠时,转移瘤的左、右叶分布无差异(P>0.05),而原发灶在右半结肠时,转移瘤的右叶优势分布多于左叶优势(P<0.001);左半结肠组内比较,甲组转移瘤的左叶优势分布多于右叶,分布差异有统计学意义(P<0.001),其左右叶构成比约为4∶1;乙组转移瘤的左、右叶分布差异不具有统计学意义(P>0.05);丙组转移瘤的右叶优势分布多于左叶优势(P<0.001);84例患者中,共发现338个肝转移灶。平扫中,低密度灶多于高密度灶,最少是等密度灶;动态CT增强扫描中,环状强化灶多于结节状强化灶,其他不典型强化灶最少,且门脉期时强化灶显示最为清晰。结论结直肠癌肝转移患者的CT肝扫描图像特点有一定规律,可以为诊断结直肠癌原发灶及结直肠癌的早期转移提供一定理论依据。

Objective To investigate the characteristics and regularity of CT imaging of colorectal cancer liver metastases.Methods A retrospective analysis of 84 cases of colorectal cancer liver metastases from March 2016 to March 2018 in our hospital.CT dynamic imaging images and clinical data were recorded and statistically analyzed for different blood flow inflows and different enhancement periods.For the CT imaging results,the patients were divided into the left colon group and the right colon group according to the primary tumor site,and the left colon group was grouped according to the blood vessel reconstruction.Results There was no statistic difference in the distribution of left and right lobe between the primary tumor and the left colon in the left colon(P >0.05).However,in the right colon,the dominant distribution of the right lobe in the metastatic tumor was more than that in the left lobe.The advantage(P=0.00)in the left colon group,the left leaf dominant distribution of the metastatic tumor of group A was more than that of the right lobe,and the difference was statistically significant(P=0.00),and the ratio of left and right lobe was about 4∶1;There was no statistic difference in the distribution of left and right leaves between group B metastases(P >0.05).The right leaf dominant distribution of group C metastases was more than that of left lobe(P=0.00).Among 84 patients,a total of 338 liver metastases were found.In the plain scan,the low-density foci were more than the high-density foci,and at least the iso-density foci;in the dynamic CT-enhanced scan,the annular intensified foci were more than the nodular intensive foci,and the other atypical intensive foci were the least,and the portal vein period enhanced stove display is the clearest.Conclusion The characteristics of CT liver scan in patients with liver metastases from colorectal cancer do have certain regularity,which may provide a theoretical basis for the diagnosis of primary colorectal cancer and early metastasis of colorectal cancer.