多层螺旋CT检查及三维重建技术在结肠癌术前诊断中的应用价值

Application Value of Multislice Spiral CT and Three-dimensional Reconstruction Technology in Preoperative Diagnosis of Colon Cancer

目的:探讨多层螺旋CT(MSCT)检查及三维重建技术在结肠癌术前诊断中的应用价值。方法:以2017年10月至2020年10月于我院拟行手术治疗的102例结肠癌患者为观察对象,患者术前均行MSCT平扫、动态增强扫描,通过三维重建技术处理图像评估肿瘤病变位置、浸润程度、邻近组织侵犯、淋巴结受累情况等,诊断肿瘤T、N分期。以术后病理结果为准,判断术前MSCT诊断效果。结果:本组102例结肠癌患者中,肿瘤病变位于乙状结肠32例,降结肠12例,横结肠8例,升结肠34例,回盲部16例;浸润型14例,溃疡型64例,肿块型24例。MSCT正确诊断T分期90例(88.2%),MSCT T分期诊断结果与术后病理T分期结果一致性好,Kappa=0.765。MSCT正确诊断N分期76例(74.5%),MSCT N分期诊断结果与术后病理T分期结果一致性较好,Kappa=0.608。结论:MSCT检查及三维重建技术可较清晰地显示肿瘤病灶位置、形态、浸润深度,用于评估术前T、N分期具有较高价值。

Objective To investigate the value of multislice spiral CT(MSCT)and three-dimensional reconstruction technology applied in the preoperative diagnosis of colon cancer.Methods The 102patients with colon cancer who were scheduled to undergo surgical treatment in author’s hospital from October 2017to October 2020were observed.All the patients underwent MSCT plain scan and dynamic enhanced scan before operation,then the images were processed by three-dimensional reconstruction technology to evaluate the location of tumor lesions,degree of infiltration,invasion of adjacent tissues and involvement of lymph nodes,so as to diagnose the T and N stages of tumor.Based on the postoperative pathological results,the diagnostic effect of preoperative MSCT was judged.Results Among the 102patients with colon cancer,the tumor lesions in 32cases were located at sigmoid colon,in 12cases at descending colon,in 8cases at transverse colon,in 34cases at ascending colon,and in 16cases at ileocecal part;there were 14cases of infiltration type,64cases of ulcer type and 24cases of mass type;90cases(88.2%)of T stage were correctly diagnosed by MSCT and the diagnostic results of MSCT T staging were consistent with the results of postoperative pathological T staging(Kappa=0.765);76cases(74.5%)of N stage were correctly diagnosed by MSCT,and the diagnostic results of MSCT N staging were consistent with the results of postoperative pathological T staging(Kappa=0.608).Conclusion MSCT and three-dimensional reconstruction can clearly show the location,shape and depth of invasion of tumor lesions.It is of high value in evaluating preoperative T and N stages.