摘要
目的探讨多层螺旋CT对结直肠癌肝脏钙化性转移瘤的诊断价值。方法选取合肥市滨湖医院2015年1月至2018年12月确诊为结直肠癌伴钙化性肝转移病人21例,均行多层螺旋CT检查,分析肝内钙化性转移瘤的影像学特征。结果21例均病理证实为非黏液腺癌,低分化2例(9.52%),中分化19例(90.48%);钙化灶形态的CT表现为细颗粒状或砂砾样钙化18例(85.71%),粗大团状钙化4例(19.05%),不规则斑片状钙化9例(42.86%);钙化分布在转移瘤的中心20例(95.24%),钙化分布在转移瘤的周边5例(23.81%)。13例增强扫描,11例出现花瓣样强化,发生率85%(11/13);2例出现环形强化,发生率15%(2/13)。右半结肠癌10例(47.62%),左半结肠癌11例(52.38%);共计检出266枚转移瘤,钙化92枚,转移瘤钙化率34.59%。右半结肠癌转移瘤共100枚,钙化58枚,钙化率58.00%(58/100);左半结肠癌转移瘤共166枚,钙化34枚,钙化率20.48%(34/166),左半结肠癌与右半结肠癌转移瘤钙化率差异有统计学意义(χ^2=38.827,P<0.001)。肝右叶转移瘤共145枚,钙化62枚,钙化率42.76%;肝左叶转移瘤共121枚,钙化30枚,钙化率24.79%(30/121),肝右叶与肝左叶转移瘤钙化率差异有统计学意义(χ^2=9.409,P=0.002)。结论右半结肠癌转移瘤钙化率明显高于左半结肠癌;肝右叶转移瘤钙化率显著高于肝左叶转移瘤钙化率;结直肠癌肝转移瘤钙化CT表现主要以细颗粒状或砂砾样钙化为主,并且大多数分布在病灶中心。
Objective To investigate the diagnostic value of MDCT in calcifying colorectal cancer liver metastases.Methods We selected twenty-one patients diagnosed as colorectal cancer with calcified liver metastases in Binhu Hospital of Hefei from 2015 to 2018 as the subjects of this study and performed a retrospective analysis.All patients underwent MDCT examination and the images were used to analyze the imaging characteristics of calcifying liver metastases.Results Twenty-one cases of colorectal cancer were confirmed by pathology as non-mucinous adenocarcinoma,with 2 cases(9.52%)poorly differentiated and 19 cases(90.48%)moderately differentiated.According to CT images,there are 18 cases(85.71%)showed fine granular or gravel calcification,4 cases(19.05%)massive calcification,9 cases(42.86%)irregular patchy calcification,20 cases(95.24%)calcification in the center of metastatic tumors,5 cases(23.81%)calcification around metastatic tumors.13 cases performed contrast-enhanced scans,petal-like enhancement was found in 11 cases,with occurrence of 85%(11/13),and annular enhancement in 2 cases 15%(2/13).There were 10 cases of right colon cancer(47.62%)and 11 cases of left colon cancer(52.38%).A total of 266 metastatic tumors were detected,92(34.59%,92/266)were calcified.A total of 100 metastases in right hemicolon,58(58.00%,58/100)were calcified,and 166 metastases in left hemicolon,34(20.48%,34/166)were calcified.The difference was statistically significant in calcification rate between left colon cancer and right colon cancer(χ^2=38.827,P<0.001).There were 145 hepatic right lobe metastases,62(42.76%,62/145)were calcified,and 121 hepatic left lobe metastases,30(24.79%,30/121)calcified.The difference was statistically significant in calcification rate between hepatic left lobe metastases and right lobe metastases(χ^2=9.409,P=0.002).Conclusion The calcification rate of right colon cancer metastases is significantly higher than that of left colon cancer.The calcification rate of right lobe metastases is significantly higher than that of left lobe metastases.The CT manifestations of calcification in colorectal cancer liver metastases are mainly fine granular or gravel calcification,and most of them are distributed in the center.
作者
王菁
巢惠民
刘文冬
王斌
WANG Jing;CHAO Huimin;LIU Wendong;WANG Bin(Department of Radiology,Binhu Hospital of Hefei,Hefei,Anhui 230051,China;CT Department,First Affiliated Hospital of Anhui Medical Univeraity,Hefei,Anhui 230022,China;Statistics Teaching and Research Section,Anhui Medical Univeraity,Hefei,Anhui 230032,China)
出处
《安徽医药》
CAS
2019年第7期1376-1380,共5页
Anhui Medical and Pharmaceutical Journal
关键词
结直肠肿瘤
肝转移瘤
继发性钙化
螺旋CT
影像学诊断
Colorectal neoplasms
Liver metastases
Secondary calcification
Spiral CT
Imaging diagnosis