CT增强扫描三维重建联合CT血管成像在结直肠癌诊断及分期中的应用

Application of CT Enhanced Three-dimensional Reconstruction Combined with CT Angiography in the Diagnosis and Staging of Colorectal Cancer

目的 探讨CT增强扫描三维重建联合CT血管成像对结直肠癌诊断及分期评估的临床价值。方法 选取143例高度疑似结直肠癌患者作为研究对象,所有患者先后行CT增强扫描三维重建、CT血管成像检查,并经组织病理学检查明确病情。统计组织病理学检查结果,并以组织病理学检查结果为金标准,分析CT增强扫描三维重建联合CT血管成像对结直肠癌诊断的敏感度、特异度及准确度,并统计CT增强扫描三维重建联合CT血管成像对结直肠癌临床分期结果及与金标准分期的一致性。结果 经组织病理学检查结果证实,143例高度疑似结直肠癌患者中,有118例结直肠癌患者,占比82.52%。118例结直肠癌患者中T1分期共15例,T2分期共22例,T3分期共53例,T4分期共28例;N0分期25例,N1分期34例,N2分期40例,N3分期19例;M0分期91例,M1分期27例。联合诊断结直肠癌的敏感度、准确度最高,其次为CT血管成像,CT增强扫描三维重建的敏感度、准确度最低,3种诊断方式比较,差异有统计学意义(P<0.05)。118例结直肠癌患者经CT增强扫描三维重建联合CT血管成像检查,共检出12例T1分期,19例T2分期,51例T3分期,28例T4分期,经Kappa一致性检验,联合诊断结果与组织病理学检查结果的一致性较好(Kappa=0.904,P=0.000);118例结直肠癌患者经CT增强扫描三维重建联合CT血管成像检查,共检出21例N0分期,32例N1分期,38例N2分期,19例N3分期,经Kappa一致性检验,联合诊断与组织病理学检查结果的一致性较好(Kappa=0.909,P=0.000);118例结直肠癌患者经CT增强扫描三维重建联合CT血管成像检查,共检出85例M0分期,26例M1分期,经Kappa一致性检验,联合诊断组织病理学检查结果的一致性较好(Kappa=0.847,P=0.000)。结论 CT增强扫描三维重建联合CT血管成像应用于结直肠癌患者临床诊断及分期评估中可提高准确度,为临床治疗提供指导。

Objective To explore the clinical value of CT enhanced three-dimensional reconstruction combined with CT angiography in the diagnosis and staging evaluation of colorectal cancer.Methods 143 patients with highly suspected colorectal cancer were selected as the research subjects.All patients underwent three-dimensional reconstruction of CT enhanced scanning,CT angiography,and histopathological examination to determine the condition.The results of histopathological examination were counted,and the results of histopathological examination were used as the gold standard to analyze the sensitivity,specificity and accuracy of CT enhanced three-dimensional reconstruction combined with CT angiography in the diagnosis of colorectal cancer,and the results of clinical staging of colorectal cancer by CT enhanced three-dimensional reconstruction combined with CT angiography and the consistency with the gold standard staging were counted.Results The results of histopathological examination confirmed that 118 of 143 patients had highly suspected colorectal cancer,accounting for 82.52%;among 118 patients with colorectal cancer,there were 15 cases in T1 stage,22 cases in T2 stage,53 cases in T3 stage and 28 cases in T4 stage;25 cases in N0 stage,34 cases in N1 stage,40 cases in N2 stage and 19 cases in N3 stage;M0 stage 91 cases,M1 stage 27 cases;the sensitivity and accuracy of combined diagnosis of colorectal cancer were the highest,followed by CT angiography and CT enhanced three-dimensional reconstruction.Compared among the 3 diagnostic methods,the difference was statistically significant(P<0.05);118 patients with colorectal cancer underwent three-dimensional reconstruction of CT enhanced scanning combined with CT angiography.A total of 12 patients with T1 stage,19 patients with T2 stage,51 patients with T3 stage and 28 patients with T4 stage were detected.By Kappa consistency test,the consistency between the joint diagnosis results and histopathological examination results was good(Kappa=0.904,P=0.000);118 patients with colorectal cancer underwent three-dimensional reconstruction of CT enhanced scanning combined with CT angiography.A total of 21 patients with N0 stage,32 patients with N1 stage,38 patients with N2 stage and 19 patients with N3 stage were detected.By Kappa consistency test,the consistency of histopathological examination results of combined diagnosis was good(Kappa=0.909,P=0.000);in 118 patients with colorectal cancer,85 patients with M0 stage and 26 patients with M1 stage were detected by CT enhanced three-dimensional reconstruction combined with CT angiography.By Kappa consistency test,the consistency of histopathological examination results of combined diagnosis was good(Kappa=0.847,P=0.000).Conclusion The application of CT enhanced three-dimensional reconstruction combined with CT angiography in colorectal cancer patients can improve the accuracy of clinical diagnosis and staging evaluation,and provide guidance for clinical treatment.