结肠癌、结肠息肉MSCT征象表现及对临床术前诊断价值研究

Study on the MSCT Signs of Colon Cancer and Colon Polyps and Their Clinical Value in Preoperative Diagnosis

目的研究结肠癌、结肠息肉多层螺旋CT(MSCT)征象表现及对临床术前诊断价值。方法选取本院2017年2月至2020年1月收治的76例结直肠占位性病变患者作为研究对象,观察MSCT表现,以病理学活检为“金标准”,分析MSCT检查对结肠癌、结肠息肉的检出情况及对结肠癌术前分期的诊断准确率。结果MSCT对结肠癌、结肠息肉的检出率分别为96.77%、92.86%,与病理学活检比较无差异(P>0.05);术前MSCT诊断结肠癌分期总准确率为95.16%。CT表现:结肠息肉呈大小不一的多发乳头状突起,表面光滑,局部黏膜无损坏;结肠癌呈现不规则软组织块影,局限性肠壁增厚,周围肠壁正常;部分可见肠腔内偏心性分叶状肿块,肠壁呈环形或半环形增厚;7例肠腔狭窄,可见密度钙化灶;8例患者筋膜间隙消失,肿块与肌肉间脂肪层消失。结论MSCT检查可清楚显示结肠癌与结肠息肉的影像学特征,可鉴别诊断结直肠占位性病变性质,术前分期诊断符合率高。

Objective To study the multislice spiral CT(MSCT)signs of colon cancer and colon polyps and their clinical value in preoperative diagnosis.Methods 76 patients with colorectal space-occupying lesions treated in our hospital from February 2017 to January 2020 were selected as the research subjects to observe the MSCT signs.Pathological biopsy was used as the"gold standard"to analyze the detection rate of colon cancer and colon polyps by MSCT and to analyze the diagnostic accuracy of MSCT for preoperative staging of colon cancer.Results The detection rates of MSCT for colon cancer and colon polyps were 96.77% and 92.86%,respectively,and there was no difference compared with pathological biopsy(P>0.05).The total accuracy of MSCT in the diagnosis of staging of colon cancer was 95.16%.CT findings:Colonic polyps show multiple papillary protrusions with various sizes and smooth surfaces and without damage to local mucosa.Colon cancer showed irregular soft tissue mass shadows,localized thickening of the intestinal wall,and normal surrounding intestinal walls.The eccentric lobular masses were seen in the partial intestinal cavity,and the intestinal wall was thickened in a circular or semi-circular shape.Seven cases had intestinal cavity stenosis and dense calcified foci can be seen.The fascial space disappeared in 8 patients,and the fat layer between the mass and the muscle disappeared.Conclusion The MSCT examination can clearly show the imaging signs of colon cancer and colon polyps,and can diagnose the nature of colorectal space occupying lesions.It has high accuracy in the diagnosis of preoperative staging.