直肠充气CT扫描在直肠癌术前诊断中的临床应用  

Clinical Application of Rectum-aerated CT in the Preoperative Diagnosis of Rectal Carcinoma

作　　者：赵刚[1] 刘世恩[2] 郭永存[3] 

机构地区：[1]青岛大学医学院附属医院肛肠科,山东青岛266003 [2]青岛大学医学院附属医院放射科,山东青岛266003 [3]即墨市第三人民医院

出　　处：《临床放射学杂志》2009年第1期70-73,共4页Journal of Clinical Radiology

摘　　要：目的探讨直肠充气CT扫描在直肠癌术前诊断中的临床应用价值。资料与方法分析经手术病理证实的67例直肠癌患者直肠充气CT扫描的表现,比较CT分期和病理分期的符合率。结果67例直肠癌的CT诊断准确率为100%;诊断直肠癌侵犯浆膜外脂肪的阳性预测值、阴性预测值、敏感性、特异性、假阳性率、假阴性率分别为93.2%、75%、96.5%、60%、40%、3.5%;诊断盆腔区域淋巴结转移的阳性预测值、阴性预测值、敏感性、特异性、假阳性率、假阴性率分别为74.2%、69.4%、67.6%、75.8%、24.2%、32.4%;CT分期和病理分期Ⅰ～Ⅲ期的符合率分别为75%、60.7%、74.2%,总符合率为68.7%。结论直肠充气CT扫描能较准确地检出直肠癌和显示浆膜外脂肪的侵犯;但对直肠癌的分期和淋巴结转移的判定仍有一定的局限性。Objective To explore the clinical value of rectum-aerated CT in the preoperative diagnosis of rectal carcinoma. Materials and Methods CT data of 67 cases with surgical pathologically verified rectal carcinoma were retrospectively reviewed to evaluate the accuracy in tumor detection and staging. Results The diagnosing accuracy of the rectal carcinoma by rectum aerated CT was 100%. The Positive predictive value,negative predictive value, sensitivity,specificity, false positive and false negative of diagnosing the fat invasion outside the plasma membrane by was 93.2% ,75% ,96.5% , 60% ,40% and 3.5%, respectively. The Positive predictive value, negative predictive value, sensitivity, specificity, false positive and false negative of diagnosing lymph nodes metastasis in cavitas pelvis by CT was 74.2%, 69.4% ,67.6% , 75.8% ,24.2% and 32.4% , respectively. The coincidence between CT and pathology staging was 75% , 60.7% and 74.2% from stage Ⅰ to Ⅲ ,respectively, and the whole coincidence was 68.7%. Conclusion Rectum aerated CT is useful for detecting rectal carcinoma and demonstrating the fat invasion outside the plasma membrane, but rectal carcinoma staging by CT and evaluating lymph nodes metastasis still have some limitation.

关 键 词：直肠癌 体层摄影术 X线计算机 临床应用 

分 类 号：R735.37[医药卫生—肿瘤] R814.42[医药卫生—临床医学]