摘要
目的探讨多期多层螺旋计算机断层扫描(MSCT)增强扫描及三维重建技术在结肠癌术前评估中的应用价值。方法选择60例行手术治疗的结肠癌患者,所有患者术前均行多期MSCT检查。以术中所见和术后病理结果为准,比较MSCT判断结肠癌征象,肿瘤累及邻近组织和血管、肿瘤分期、肠系膜血管分布与术中所见和术后病理的一致性。结果MSCT术前诊断结肠癌T分期正确48例,诊断准确度为80.00%(48/60),与病理结果的一致性较好(P﹤0.01)。MSCT术前显示肿块边缘不规则、肠壁增厚、肠腔狭窄、病灶累及浆膜层、病灶累及邻近组织器官、肠梗阻、腹膜后淋巴结转移,术前评估病灶累及肠系膜上动脉、肠系膜上静脉、肠系膜下动脉、肠系膜下静脉、腹主动脉、肾动脉、肾静脉、脾动与术中所见以及术后病理结果均具有良好的一致性(P﹤0.01)。术前MSCT评估肠系膜血管受累与术中所见符合53例,MSCT对肠系膜血管受累的诊断灵敏度、特异度及准确度分别为83.33%、95.83%和88.33%。结论多期MSCT增强扫描联合三维重建技术可有效评估结肠癌术前肿瘤分期、肿瘤侵犯程度以及肠系膜血管分布,为手术方案的制订提供可靠依据。
Objective To evaluate the application value of multi-phase multi-slice spiral computed tomography(MSCT)enhanced scanning and three-dimensional reconstruction in preoperative evaluation of colon cancer.Method A total of 60 patients with colon cancer administered with surgery were included,all patients underwent multi-phase MSCT examination before operation.The intraoperative and postoperative pathological findings were taken as the gold standard,and MSCT was used to determine the signs of colon cancer,the involvement of adjacent tissues and blood vessels,tumor staging,the distribution of mesenteric vessels,and the consistency with intraoperative findings and postoperative pathology.Result Among these patients,48 cases of colon cancer were diagnosed with correct T staging before surgery by MSCT,and the diagnostic accuracy was 80.00%(48/60),which was in good agreement with the pathological results(P<0.01).MSCT showed irregular margin,intestinal wall thickening,intestinal stenosis,involvement of serosa,involvement of adjacent tissues and organs,intestinal obstruction,retroperitoneal lymph node metastasis before operation,preoperative evaluation of the involvement of cancer in superior mesenteric artery,superior mesenteric vein,inferior mesenteric artery,inferior mesenteric vein,abdominal aorta,renal artery,renal vein,and splenic artery were in good agreement with those observed during operation and postoperative pathology(P<0.01).Preoperative MSCT evaluation of mesenteric vascular involving with intraoperative findings in 53 cases.The diagnostic sensitivity,specificity and accuracy of MSCT for mesenteric vascular involvement were 83.33%,95.83%and 88.33%,respectively.Conclusion Multi-phase MSCT enhanced scanning combined with three-dimensional reconstruction can be utilized to effectively evaluate the preoperative staging,invasion degree and mesenteric vascular distribution of colon cancer,and provide a reliable basis for surgical planning.
作者
管庶春
顾勤
吴徐峰
唐会峰
程云
GUAN Shuchun;GU Qin;WU Xufeng;TANG Huifeng;CHENG Yun(Department of Radiology,Changzhou No.7 People’s Hospital,Changzhou 213011,Jiangsu,China;Trauma Center,Changzhou No.7 People’s Hospital,Changzhou 213011,Jiangsu,China;Center for Gastrointestinal Disease,Changzhou No.7 People’s Hospital,Changzhou 213011,Jiangsu,China)
出处
《癌症进展》
2019年第24期2921-2924,共4页
Oncology Progress
关键词
多层螺旋CT
三维重建
结肠癌
肿瘤分期
肠系膜
multi-slice spiral computed tomography
three-dimensional reconstruction
colon cancer
cancer staging
mesentery
作者简介
通信作者:管庶春,邮箱:gshchwj@126.com。
