结肠水灌肠MSCT对大肠癌与大肠炎的诊断价值  

Diagnostic Value of Colon Water Enema MSCT for Large Bowel Cancer and Inflammation

作　　者：赵锡海[1] 许建荣[1] 龚红霞[1] 路青[1] 华佳[1] 

机构地区：[1]上海第二医科大学附属仁济医院放射科,研究生200001

出　　处：《中国医学计算机成像杂志》2005年第1期39-43,共5页Chinese Computed Medical Imaging

摘　　要：目的分析大肠癌与大肠炎的结肠水灌肠MSCT征象、病变径线值及CT值变化特点,探讨此种检查方法对大肠癌与大肠炎的诊断与鉴别诊断价值。材料和方法46例行结肠水灌MSCT检查的患者,大肠癌34例,大肠炎12例。分析大肠癌及大肠炎各种征象(如浆膜浸润征、表面毛糙征、肠壁分层征等),计算出各种征象的出现率。测量所有大肠病变的纵径、横径及增强前后的平均CT值,比较肠癌与肠炎病变径线值及增强前后CT值变化有无差异。结果结肠水灌肠MSCT上大肠癌征象如表面毛糙征、浆膜面浸润、局部系膜浸润及血管纹理增生具有较高的出现率,上述征象与肠旁结节征、系膜网膜结节征出现率均明显高于肠炎,肠壁分层征则相反。大肠炎病变纵径明显大于肠癌,横径小于肠癌。肠炎与肠癌增强前后CT值均有显著性差异,肠癌平均CT值高于肠炎,但强化幅度无显著差异。结论大肠癌大部分MSCT征象、病变径线值及增强前后CT值变化与肠炎均有显著差异。结肠水灌肠MSCT显示大肠癌与肠炎各种征象更敏感、丰富、全面、准确,具有较高的诊断与鉴别诊断价值。Purpose:To assess the diagnostic value of colonic water enema MSCT for large bowel cancers and inˉflammations by comparing the various features,the lesions sizes and CT enhanced attenuation between large bowel cancers and large bowel inflammations on colon water enema MSCT images.Materials and Methods:46cases with large bowel cancers(34cases)and inflammations(12cases)were validated by surgery,endoscopic and histographic examinations.All cases were prepared with colonic water enema about1500～2000ml and performed MSCT pre-/post-enhanced examinations.The varios MSCT signs(including serous membrane infiltration,coarse surface,wall enema,et al)of large lowel cancer and inflammation lesions were reviewed,the horizontal/longitudinal sizes and pre-/post-enhanced CT atˉtenuation of cancer and inflammation lesions were measured and compared by two radiologists.The statistic analysis included t-test and chi-square test.Results:The occurrence frequency of coarse surface,serous membrane infiltration,local mesenteric infiltration,pericolon masses/nodes and mesenˉteric vascular hyperplasia of colon cancer wall were more higher than that of colonic inflammation,but the laminal sign of inflammatory colon wall was more visualized than that of large bowel cancers.There were significant differences in the lesions sizes between large bowel cancers and inflammations(P>0.05),i.e the longitudinal sizes of inflammatory lesions were longer than that of cancers lesions,and reversely the honrozontal sizes of cancers lesions were thicker than that of finflammatory lesions.There were significant differences of enhanced attenuation value(P> 0.05), but no obvious difference of enhanced degree between large bowel cancers and inflammations(P> 0.05) .Conclusion: Colonic water enema MSCT is an accurate and sensitive method for identifying various features of large bowel disease, and representing significant differences in pre-/ post-enhanced CT attenuation and longitudinal/ horizontal sizes between large bowel cancer and inflammation lesions.E

关 键 词：结肠水灌肠 MSCT 大肠癌 大肠炎 诊断 

分 类 号：R735.34[医药卫生—肿瘤] R574.6[医药卫生—临床医学]