螺旋CT扫描对中晚期直肠癌的诊断价值  

The Diagnosic Value of Preoperative Spiral CT Scanning in Middle-late Stage Rectal Carcinoma

作　　者：石桥[1] 王维[2] 刘晟[2] 罗贤明[2] 欧阳彬[2] 

机构地区：[1]北京大学深圳医院放射科,广东深圳518036 [2]中南大学湘雅三医院放射科

出　　处：《中国医师杂志》2005年第4期479-481,共3页Journal of Chinese Physician

摘　　要：目的评价螺旋CT扫描对中晚期直肠癌诊断、分期的价值。方法回顾性分析34例经螺旋CT扫描诊断为中晚期直肠癌并且与纤维肠镜活检及其手术、病理结果对照。结果所有螺旋CT扫描均显示为中晚期直肠癌,主要表现为肠管环形或半环形增厚、局部肿块形成、肠管周围浸润、肠腔狭窄、局部或远处淋巴结肿大(直径≥10mm)及其远处器官转移。按照改良Duke’s分期与病理结果对照,总符合率为70.6%其中B1,B2,C,D分期病例敏感性分别为83.3%,50%,66.7%,78.5%,特异性分别62.5%,44.4%,57.1%,100%;按照TNM分期与病理结果对照T分期总符合率为73.5%,其中T2,T3,T4分期敏感性分别为85.7%,61.5%,78.6%,特异性分别54.5%,66.7%,100%。结论螺旋CT扫描对于中晚期直肠癌的肠周浸润范围、盆腔淋巴结转移特别是远处转移具有较肯定的诊断价值。Objective To evaluate the value of preoperative spiral CT (SCT) scanning in the diagnosis and staging of middle-late stage rectal carcinoma. Methods The results of SCT scanning of 34 patients with middle-late stage rectal carcinomas were compared with the pathological examination results and the findings of surgical operation. Results SCT could display the manifestations of middle-late stage rectal carcinoma, such as rectal wall thickening, local tumor mass, tumor invasion of rectal circumference, narrow rectal cava, lymph node enlarging (diameter≥10mm) and tumor distant metastasis. According to Duke's staging, the overall accuracy of SCT staging was 70.6%, and for the stages B1, B2, C, and D the sensitivity was 83.3%, 50%, 66.7%, 78.5%, and the specificity was 62.5%, 44.4%, 57.1%, 100%, respectively. According to TNM staging, the overall accuracy of SCT was 73.5%, and for the stages T2, T3, T4 the sensitivity was 85.7%, 61.5%, 78.6%, and the specificity was 54.5%, 66.7%, 100%, respectively. Conclusion Preoperative SCT could display the invasive range of middle-late stage rectal carcinoma and the tumor lymph nodes metastasis, especially distant metastasis, and had a definite diagnostic value.

关 键 词：中晚期直肠癌 螺旋CT扫描 诊断价值 盆腔淋巴结转移 CT扫描诊断 病理结果 回顾性分析 淋巴结肿大 TNM分期 肠镜活检 主要表现 肿块形成 肠腔狭窄 器官转移 浸润范围 远处转移 符合率 敏感性 特异性 对照 半环形 T分期 肠管 

分 类 号：R735.3[医药卫生—肿瘤]