256层螺旋CT动态增强及多模式后处理技术在结肠癌术前诊断及分期中的应用价值

Application value of dynamic enhancement and multi reconstruction mode with 256 slice spiral CT in the preoperative diagnosis and staging of colon cancer

目的探讨256层螺旋CT(MSCT)动态增强及多模式后处理技术在结肠癌术前诊断及分期中的应用价值。方法收集2015年12月至2018年12月,芜湖市第一人民医院51例术后病理诊断及TNM分期的结肠癌病人,采用256层螺旋CT(MSCT)对51例结肠癌病人术前进行腹部CT平扫、动态增强及多模式图像后处理检查,评估病变的部位、形态、范围、浸润程度、强化程度、邻近组织侵犯、引流淋巴结受累、远处转移情况,进行CT术前诊断及TNM分期,与术后病理诊断及TNM分期的金标准进行对照。结果256层螺旋CT(MSCT)术前T分期与术后病理T分期比较,≤T2期准确率为98.04%(50/51),T3期准确率为88.24%(45/51),T4期准确率为90.20%(46/51),一致性好(K=0.766,χ^2=65.623,P<0.05)。术前MSCT N分期与术后病理N分期比较,N0准确率为90.20%(46/51),N1期准确率为76.47%(39/51),N2期准确率为82.35%(42/51),一致性较好(K=0.611,χ^2=40.937,P<0.05)。结论256层螺旋CT(MSCT)动态增强及多模式后处理技术对结肠癌病人的术前诊断及分期具有重要价值,为临床选择合理的治疗方案及术前评估提供帮助。

Objective To evaluate the value of dynamic enhancement and multi reconstruction mode with 256 slice spiral CT(MSCT)in the preoperative diagnosis and staging of colon cancer.Methods From December 2015 to December 2018,51 colorec tal cancer patients with postoperative pathological diagnosis and TNM staging were collected from Wuhu First People’s Hospital and underwent abdominal CT plain scan,dynamic enhancement and multi mode reconstruction before operation with 256 slice spi ral CT(MSCT).The location,shape,extent,depth of invasion,degree of enhancement,adjacent tissues invasion,draining lymph nodes involvement and distant metastasis were carefully evaluated.Preoperative CT diagnosis and TNM staging were compared with postoperative pathological results and golden standard of TNM staging.Results Compared with the postoperative pathological re sults,T staging accuracy rates of preoperative MSCT were as follows:≤T2 stage was 98.04%(50/51),T3 stage was 88.24%(45/51),T4 stage was 90.20%(46/51),with very good consistency(K=0.766,χ^2=65.623,P<0.05).N staging accuracy rates of preop erative MSCT were as follows:N0 stage was 90.20%(46/51),N1 stage was 76.47%(39/51),N2 stage was 82.35%(42/51),with good consistency(K=0.611,χ^2=40.937,P<0.05).Conclusion Dynamic enhancement and multi reconstruction mode with 256 slice spiral CT is of great value in the preoperative diagnosis and staging of colon cancer patients,which can provide valuable infor mation for the selection of reasonable treatment and preoperative evaluation.