多层螺旋CT三维成像技术对结肠癌的诊断效能分析

Analysis of the diagnostic efficacy of multi-slice spiral CT three-dimensional imaging in the colon cancer

目的分析多层螺旋CT(MSCT)三维成像技术对结肠癌的诊断效能。方法选取2019年2月至2022年2月江西省上饶市立医院收治的82例结肠癌患者作为研究对象,另选取同期本院41例结肠良性肿瘤患者纳入研究。所有患者术前均行MSCT三维成像技术检查,以病理组织学结果为金标准,评估结肠肿瘤良恶性、结肠癌组织病理结构及术前结肠癌T、N分期的诊断效能。结果以病理组织学结果为金标准,经MSCT检查诊断,良性肿瘤9例,结肠癌76例,结肠良性肿瘤47例,MSCT检查准确率为90.24%,灵敏度为89.02%,特异度为92.68%,阳性预测值为96.05%,阴性预测值为80.85%,MSCT检查与病理组织学结果一致性较好(Kappa=0.788)。82例结肠癌患者中,降结肠4例,横结肠9例,直肠17例,乙状结肠20例,升结肠和盲肠32例。MSCT三维重建诊断侵及结肠固有肌层的准确率为93.62%,诊断结肠癌浸润结肠全层的准确率为100.00%,诊断侵及结肠黏膜下层的准确率为94.12%,诊断侵及黏膜下层的准确率为100.00%;MSCT检查准确率为95.12%;MSCT三维重建与病理组织学病理表现结果一致性极佳(Kappa=0.920)。MSCT三维重建诊断结肠癌≤T2期的准确率为57.14%,诊断结肠癌T3期的准确率为90.48%,诊断结肠癌T4期的准确率为92.59%;MSCT三维重建诊断T分期的准确率为89.02%;MSCT三维重建与病理组织学T分期检查结果一致性较好(Kappa=0.777)。MSCT三维重建诊断结肠癌N0期的准确率为93.33%,诊断结肠癌N1期的准确率为72.22%,诊断结肠癌N2期的准确率为75.00%;MSCT三维重建诊断N分期的准确率为80.49%;MSCT三维重建与病理组织学N分期结果的一致性较好(Kappa=0.699)。结论MSCT三维重建技术可清晰反映肿瘤的病灶位置、组织形态和结构,对结肠肿瘤良恶性具有较高的诊断价值,可用于评估术前病理分期,为制订合适的治疗方案提供依据。

Objective To analyze the diagnostic efficacy of multi-slice spiral CT(MSCT)three-dimensional imaging in the colon cancer.Methods 82 patients with colon cancer admitted to Shangrao Municipal Hospital from February 2019 to February 2022 were selected as the research subjects,and 41 patients with benign colon tumors in our hospital during the same period were included in the study.All patients were examined by MSCT three-dimensional imaging technique before operation,the histopathological results were used as the gold standard to evaluate the benign and malignant colon tumors,the pathological structure of colon cancer tissues and the diagnostic efficacy of preoperative T and N staging of colon cancer.Results With histopathological results as the gold standard,9 cases of benign tumors,76 cases of colon cancer and 47 cases of benign colon tumors were diagnosed by MSCT,the accuracy of MSCT examination was 90.24%,the sensitivity was 89.02%,the specificity was 92.68%,the positive predic-tive value was 96.05%,and the negative predictive value was 80.85%,the consistency between MSCT examination and histopathological results was good(Kappa=0.788).Among the 82 patients with colon cancer,there were 4 cases of descending colon,9 cases of transverse colon,17 cases of rectum,20 cases of sigmoid colon,and 32 cases of ascending colon and cecum,the accuracy of MSCT three-dimensional reconstruction in the diagnosis of inva-sion of the muscularis propria layer of the colon was 93.62%,the accuracy of diagnosis of colon cancer invasion of the whole colon was 100.00%,the accuracy of diagnosis of invasion of the submucosa of the colon was 94.12%,and the accuracy of diagnosis of invasion of the submucosa was 100.00%,the accuracy of MSCT examination was 95.12%,the consistency between MSCT three-dimensional reconstruction and histopathological findings was excellent(Kappa=0.920).The accuracy of MSCT three-dimensional reconstruction in the diagnosis of colon cancer≤T2 stage was 57.14%,the accura-cy in the diagnosis of colon cancer T3 stage was 90.48%,and the accuracy in the diagnosis of colon cancer T4 stage was 92.59%,the accuracy of MSCT three-dimensional reconstruction in the diagnosis of T staging was 89.02%,the consistency between MSCT three-dimensional reconstruction and histo-pathological T staging was good(Kappa=0.777).The accuracy of MSCT three-dimensional reconstruction in the diagnosis of N0 stage of colon cancer was 93.33%,the accuracy in the diagnosis of N1 stage of colon cancer was 72.22%,and the accuracy in the diagnosis of N2 stage of colon cancer was 75.00%,the accuracy of MSCT three-dimensional reconstruction in the diagnosis of N staging was 80.49%,the consistency between MSCT three-di-mensional reconstruction and histopathological N staging results was good(Kappa=0.699).Conclusion MSCT three-dimensional reconstruction tech-nology can clearly reflect the location,tissue morphology and structure of the tumor,and has a high diagnostic value for benign and malignant colon tu-mors,it can be used to evaluate preoperative pathological staging and provide a basis for formulating appropriate treatment plans.