结肠肿瘤MSCT的诊断价值  

Diagnosis of Colonic Neoplasm with MSCT

作　　者：汤小俐 许秋霞[2] 滑炎卿[3] 项平[3] 殷于磊[3] 陆孝禹[3] 徐富星[3] 

机构地区：[1]广东深圳蛇口联合医院放射科,518067 [2]河南科技大学附属第二医院,洛阳471002 [3]上海华东医院,200040

出　　处：《临床放射学杂志》2007年第4期367-370,共4页Journal of Clinical Radiology

摘　　要：目的探讨多层螺旋CT（MSCT）对结肠肿瘤的诊断价值。资料与方法回顾性分析36例经病理证实的结肠肿瘤患者的临床、MSCT和肠镜检查资料,全部病例术前均经16层螺旋CT平扫和增强扫描,依据需要行薄层重组和多平面重组（MPR）。对肠道准备良好者行CT仿真内镜（CTVE）、表面遮盖成像（SSD）及透明化处理,将MSCT图像与肠镜检查所见进行对照。采用Borrman法对MSCT所见病变进行分型。结果36例术前MSCT全部诊断为恶性肿瘤,其中隆起型（BorrmanⅠ）25例,溃疡型（BorrmanⅡ-Ⅲ）8例,浸润型（BorrmanⅣ）3例。28例结肠镜检查有效,其余病例因肠梗阻、深度不到位、进镜困难导致肠镜检查失败。病理诊断：中分化腺癌27例,低分化腺癌2例,高分化腺癌2例,黏液腺癌1例,未分化癌1例,多灶性中低分化腺癌及腺瘤并存3例。结论MSCT可快速、无创、敏感地发现结肠肿块性病变,并可对病变的定位、定性、术前分期及预后提供准确的信息,可弥补常规钡剂灌肠和纤维结肠镜检查的不足。Objective To evaluate the diagnostic value of colonic neoplnsm with multi slice computed tomography （MSCT）. Materials and Methods The MSCT, endoscope and clinic data of 36 patients with the colonial neoplasm confirmed by pathology were retrospectively analyzed .All cases underwent pre and post contrast MSCT scan. MPR, CT virtual colonoscopy （CTV） and SSD were reconstructed on the Wizard workstation. The MSCT appearances of colonic neoplasm were compared to the findings of colonoscopy. Results According to the Bortmans system, the neoplasm of 36 cases could be classified into the upheaval type （Borrman Ⅰ , n = 25）, ulcer type（Borrman Ⅱ - Ⅲ , n = 8）and infiltration type（Borrman Ⅳ, n = 3）on the MSCT. The pathologic results were 34 cases with adencarcinoma （ middle differentiation 27 cases, high differentiation 2 cases and low differentiation 2 cases）, 1 case with , and 1 case with undifferentiated carcinoma. The other pathological types included the multisite carcinomas and/or coexistence with adenomas in 3 cases. Colonoscopy was performed successfully in 28 cases, and the rest were failure because of various reasons. Conclusion MSCT plays a critical role in the diagnosis of colonic neoplasm, and is a complementary method to colonoscopy and barium enema.

关 键 词：结肠肿瘤 纤维结肠镜 体层摄影术 X线计算机 

分 类 号：R735.35[医药卫生—肿瘤]