低剂量CT结肠成像与内镜检查在诊断结肠癌中的价值比较  

Comparison of low-dose CT colonography and sigmoidoscopy in the diagnosis of colon carcinoma

作　　者：李家言[1] 何欣[1] 高春萍[1] 马娜[1] 张家宙[1] 韦兰珍 陈燕静[1] 梁雪[1] 欧海玲[1] 黄小明[1] 

机构地区：[1]广西中医药大学第一附属医院放射科,南宁530023

出　　处：《中国临床新医学》2015年第4期346-349,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨低剂量CT结肠成像(CTC)与内镜检查评估结肠癌有无、肿块部位、分型的一致性。方法对65例经病理证实结肠癌患者行结肠低剂量CT扫描及内镜检查,观察结肠癌有无、肿块部位、分型。以病理结果作为金标准,对CTC与内镜判断结肠癌有无、肿块部位、分型行Kappa一致性检验,并记录扫描的CT剂量指数(CTDIw)。结果内镜诊断结肠癌阴性4例,阳性61例,肿块位于直肠8例,乙状结肠25例,降结肠13例,横结肠11例,升结肠8例;肿块Ⅰ型38例,Ⅱ型14例,Ⅲ型7例,Ⅳ型6例。CTC判断结肠癌阴性5例,阳性60例,肿块位于直肠8例,乙状结肠25例,降结肠16例,横结肠10例,升结肠6例;肿块Ⅰ型36例,Ⅱ型16例,Ⅲ型7例,Ⅳ型6例。CTC与内镜CRC诊断结果一致性较高(Kappa=0.881,P<0.01);CTC诊断结肠癌的符合率为98.5%。CTC与内镜CRC的结肠癌肿块部位、分型结果一致性较高(Kappa值分别为0.897和0.949,P均<0.01)。结论辐射剂量降低至1.68 m Gy的CTC诊断结肠癌及肿块部位、分型,与内镜诊断有较高的一致性。Objective To study the consistence of low-dose CT colonography （ CTC） and sigmoidoscopy in the diagnosis, site and classification of colon carcinoma （CRC）.Methods A total of 65 patients of CRC were con-firmed by pathology .All the patients were examined by endoscopy and low doses CTC .The location, types of tumour were observed by endoscopy and CTC , and Kappa consistence test was applied with the pathologic findings as golden standard, and calculated CT dose index（CTDIw） in prone was recorded.Results Sixty-one patients were diagnosed as having CRC by endoscopy and 4 were negative .In 61 positive patients , 8 tumors located in the rectum , 25 in the colon sigmoideum , 13 in the descending colon , 11 in the colon transversum , 8 in the ascending colon , and Borrmann showed,Ⅰin 38,Ⅱin 14,Ⅲin 7,Ⅳin 6.CTC diagnosed 60 cases of CRC and 5 cases with negative results .In 61 positive patients , 6 tumors located in the rectum , 23 in the colon sigmoideum , 15 in the descending colon , 10 in the colon transversum, 6 in the ascending colon, and Borrmann showed,Ⅰin 36,Ⅱin 16,Ⅲin 7,Ⅳin 6.There was high consistency between CTC and sigmoidoscopy in the diagnosis of CRC （ Kappa=0.881 , P〈0.01 ） , with the coincidence of CTC was 98.5%.There was high consistency between CTC and sigmoidoscopy in the classification of CRC（ Kappa values were 0.897 and 0.949 , P〈0.01 ） .Conclusion Reduction of the effective dose to 1.68 mGy significantly affects images quality on CTC , there is high consistency between CTC and sigmoidoscopy in the diagno-sis, site and classification of CRC .

关 键 词：结肠癌 肿块 结肠成像 X线计算机体层摄影术 辐射剂量 

分 类 号：R735.35[医药卫生—肿瘤]