多期动态增强CT术前预测结直肠癌脉管癌栓的诊断价值

Diagnostic value of contrast-enhanced CT in the preoperative prediction of vessel invasion of colorectal cancer

目的探讨多期动态增强CT术前预测结直肠癌脉管癌栓状态的诊断价值。方法选取我院72例结直肠癌患者术前多期动态增强CT图像及术后病理信息,测算20个CT值相关定量参数,包括肿瘤各期CT值的最大值、最小值、均值、各期最大值与最小值的差值、增强各期与平扫CT值的均值、最大值、最小值的差值(ΔAMean、ΔAMax、ΔAMin、ΔPMean、ΔPMax、ΔPMin)和对比增强比(CERA、CERP),所有参数行正态分布检验,依据结果采用非参数Mann-Whitney U检验分析不同癌栓状态的病灶CT值差异,最后应用受试者工作特征曲线(ROC曲线)分析其诊断效能。结果72例患者中20例(27.8%)脉管癌栓阳性,与阴性病例相比ΔPMean显著增大(P<0.05),ROC曲线下面积为0.662。其余参数无显著差异。结论多期动态增强CT对术前预测结直肠癌脉管癌栓状态有帮助。

Objective To retrospectively identify the value of computed tomographic(CT)values in surgically resected colorectal cancer in predicting vessel invasion.Methods The preoperative multi-phase dynamic enhanced CT images and postoperative pathological information of 72 patients with colorectal cancer in our hospital were retrospectively collected,and 20 quantitative parameters related to CT values were calculated,including the maximum,minimum and average CT values of different phases of the tumors,the difference between the maximum and minimum values in each period,the difference between the maximum,minimum and average values of enhanced phases and the value of nonenhanced phases(ΔAMean,ΔAMax,ΔAMin,ΔPMean,ΔPMax,ΔPMin)and contrast enhancement ratio(CERA,CERP).All parameters were tested for normal distribution.According to the results,the variables were determined by non-parametric Mann-Whitney U test to analyze the difference between the CT values of lesions with different tumor thrombus states.At last,receiver operating characteristic curve was employed to compare the diagnostic performance.Results Of all the 72 patients,20(27.8%)had vessel invasion.Compared with patients without vessel invasion,ΔPMean increased(P<0.05),the area under receiver operating characteristic curve was 0.662.Conclusion Contrast-enhanced CT value is helpful for preoperative prediction of vascular thrombus in colorectal cancer.