结肠充气造影CT低剂量平扫与常规剂量增强扫描结合应用对结肠癌的诊断价值  

Diagnostic value of CT pneumocolon low dose scanning and routine dose enhancement scanning in diagnosis of colon cancer

作　　者：赵兴家 孙伟明[2] 宋玉卿 马进元 范志奎 

机构地区：[1]承德钢铁公司职工医院放射科,河北承德067002 [2]承德市中心医院CT科

出　　处：《现代预防医学》2012年第21期5659-5661,共3页Modern Preventive Medicine

摘　　要：目的对结肠充气造影CT低剂量平扫与常规剂量增强扫描结合应用对结肠癌的诊断价值进行探讨。方法选择2009年3月～2010年7月在某医院收治的结肠癌患者32例,年龄22～64岁,平均41.8岁。采用德国西门子公司生产的SOMATOM Sensation16螺旋CT机。体位:仰卧位;范围:双膈顶至耻骨联合下缘;扫描方向:头一足方向;记录每次扫描的辐射剂量。每例患者的4种图像进行增强对增强、平扫对平扫的图像质量对比,由1位CT主管技师、l位CT诊断主治医师、1位外科副主任医师共同对病灶显示的清晰度和图像的器官等进行评定,分析与诊断由2位高年资CT诊断医师共同进行。结果 CT检出阴性预测值76.9%,阳性预测值95.5%。诊断敏感度93.3%,误漏诊5例,检出大肠病变46例,准确率91.2%,特异度73.3%。结论只有将常规剂量增强扫描与结肠充气造影MSCT低剂量平扫进行相互的结合,才可以进行结肠癌的早期诊治及预后评估。这样做能够不影响分期诊断、定性诊断的检查效果,又能够降低了受检者接受的辐射剂量,是一种具有实用价值的扫描技术。OBJECTIVE To discuss the application value of combined use of CT pneumocolon low dose scanning with routine dose enhancement scanning in the diagnosis of colon cancer.METHODS From March 2009 to July 2010,32 patients with colon cancer were selected in a hospital,age 22-64 year old,average 41.8 years old.By using Siemens SOMATOM Sensation 16 spiral ct.Position：supine;range：double diaphragm top to the lower margin of pubic bone;scanning direction：the first foot direction;a record of each scanning radiation dose.4 kinds of imaging ineach patient were compared as enhancement to enhancement,scan to scan.The clarity of lesions and images of organ were evaluated by 1 CT chief technician,l attending physician in CT diagnosis,1 d associate chief physician in department of surgery,analysis and diagnosis were conducted by 2 senior physicians in CT diagnosis.RESULTS The CT positive and negative predictive value was 76.9%,positive predictive value was 95.5%.Diagnostic sensitivity was 93.3%,missed diagnosis was in 5 cases,the detection of colorectal lesions was in 46 cases,the accuracy rate was 91.2%,specificity 73.3%.CONCLUSION Only the conventional dose enhancement scanning and CT pneumocolon low dose scanning are mutually combined,can undertake early diagnosis and prognostic assessment of colon cancer.It will not influence the staging diagnosis,qualitative diagnosis examination of the effect,and can reduce the radiation dose received by subjects.It is a kind of practical scanning technology.

关 键 词：结肠充气造影 CT低剂量平扫 螺旋计算机 

分 类 号：R445.3[医药卫生—影像医学与核医学]