粘液性/非粘液性结直肠癌MSCT征象及鉴别诊断价值研究

Signs and Differential Diagnostic Value of Multislice Spiral CT(MSCT)in Mucinous/Non-mucinous Colorectal Cancer

目的研究粘液性/非粘液性结直肠癌多层螺旋CT(MSCT)征象及鉴别诊断价值。方法选取本院2016年2月至2019年9月收治的130例结直肠癌患者作为研究对象,分析粘液性和非粘液性结直肠病灶的直径、密度、形态等MSCT征象及MSCT鉴别诊断粘液性和非粘液性结直肠癌的灵敏度、特异度及准确度。结果粘液性与非粘液性结直肠癌的病变部位、形态、肠管长度、肿块直径比较无显著差异(P>0.05);粘液性结直肠癌管壁增厚类型以非均匀同心型多见,增强扫描多呈非均匀同等程度强化,低密度区范围通常大于肿瘤2/3,瘤内钙化较非粘液性结直肠癌多见,且肠管厚度明显大于非粘液性结直肠瘤,两者在管壁增厚类型、强化方式、强化程度、低密度区范围、肿瘤内钙化及病变肠管厚度上比较差异显著(P<0.05)。MSCT检查鉴别诊断粘液性和非粘液性结直肠癌的灵敏度、特异度、准确度分别为84.21%、90.41%、87.69%。结论MSCT可清晰显示粘液性与非粘液性结直肠癌的影像学特征,可作为术前鉴别诊断两者的有效检查方法。

Objective To study the signs and differential diagnostic value of multislice spiral CT(MSCT)in mucinous/non-mucinous colorectal cancer.Methods 130 patients with colorectal cancer treated in our hospital from February 2016 to September 2019 were selected as the research objects.The MSCT signs such as diameter,density and morphology of mucinous and non-mucinous colorectal lesions,and the sensitivity,specificity and accuracy of MSCT in the differential diagnosis of mucinous and non-mucinous colorectal cancer were analyzed.Results There was no difference in the lesion site,morphology,intestinal length,and mass diameter between mucinous and non-mucinous colorectal cancer(P>0.05).The thickening of tube wall in mucinous colorectal cancer was more common with non-uniform concentric types.Enhancement scans often showed non-uniform enhancement in equal measure.The low-density area was usually larger than 2/3 of the tumor.Intratumoral calcification was more common than that of non-mucinous colorectal cancer,and the thickness of the intestine was significantly larger than that of non-mucinous colorectal tumor.There were significant differences in the type of wall thickening,the strengthening method,the degree of strengthening,the range of the low-density area,the calcification in the tumor,and the thickness of the intestinal tube of the lesion between them(P<0.05).The sensitivity,specificity,and accuracy of MSCT in the differential diagnosis of mucinous and non-mucinous colorectal cancer were 84.21%,90.41%,and 87.69%,respectively.Conclusion MSCT can clearly show the imaging characteristics of mucinous and non-mucinous colorectal cancer,and it can be used as an effective examination method for the differential diagnosis of them.