常规CT检查结肠癌的表现特点  

The features of colon carcinoma on conventional CT

作　　者：上官景俊[1] 王家臣[2] 李文[3] 

机构地区：[1]山东大学齐鲁医院(青岛)放射科,山东青岛266035 [2]青岛大学医学院附属医院放射科,山东青岛266555 [3]山东省千佛山医院核医学科,山东济南255014

出　　处：《医学影像学杂志》2015年第6期1033-1037,共5页Journal of Medical Imaging

摘　　要：目的探讨未做肠道准备情况下结肠癌的CT表现特点,以提高病变检出率。方法回顾性分析因胃肠道症状就诊并进行CT检查的62例临床未触及包块、手术或结肠镜病理证实为结肠癌的患者资料,观察并记录各种CT表现特点和诊断结果,将CT诊断阳性率与各种征象进行统计学分析,并将肠壁外缘改变与T分期及其余CT征象进行相关分析。结果 CT诊断阳性率为56.5%,显示管径增粗、管壁增厚、管腔狭窄、腔内隆起、外缘模糊、脂肪异常的例数分别占总数的83.9%、87.1%、38.7%、29.0%、62.9%、83.9%,62.9%的病变与邻近肠管界限清楚,24.2%可见淋巴结肿大,4.8%有远处转移,所有增强扫描病例病变肠管均呈不均匀强化。统计学分析显示:CT诊断阳性率与肠管管径、管壁、外缘、邻近脂肪的改变,以及与周围肠管界限是否清楚及淋巴结大小等因素有关;管径增粗成块时,阳性诊断率明显增加;肠壁外缘改变与T分期、管径增粗、管壁增厚、脂肪异常呈正相关。结论在未做肠道准备情况下,通过仔细观察CT能发现大部分结肠癌并具有一定特点,其中管径增粗、管壁增厚、外缘模糊、脂肪异常对于提示结肠癌的存在有重要作用。Objective To investigate the CT features of colon carcinoma without bowel preparation so as to improve the diagnostic accuracy .Methods 738 patients with acute abdomen presenting to the emergency department underwent CT scanning and their data were reviewed retrospectively .The CT findings of 62 patients with colon carcinoma proved by pa‐thology after surgery or colonscopy and without mass on physical examination were assessed by two observers for the pres‐ence or absence of the enlarging of the bowel ,the wall thickening ,the luminal narrowing ,the protrusion of the wall into lumen ,the misty margin ,the pericolic fat stranding ,the focalization of the lesions ,the enlargement of regional nodes and the enhancement of lesions and distant metastases .The relationship between CT detection rate and its features of colon carcinomas ,and association between the misty margin on CT images and T‐stage and other CT appearances were analyzed statistically .Results 56 .5% of patients demonstrated the lesions .There were 83 .9% （52/62） of patients with the enlar‐ging of the bowel ,87 .1% （54/62） of the wall thickening ,38 .7% （24/62） of the luminal narrowing ,29 .0% （18/62） of the protrusion of the wall into lumen ,62 .9% （39/62） of the misty margin ,83 .9% （52/62） the fat stranding ,respectively , and 62 .9% （78/124） of lesions were focal ,24 .2% （15/62） of patients had enlarged regional nodes ,4 .8% （3/62） of pa‐tients had distant metastases .All the lesions were enhanced heterogeneously .The detection rate of CT correlated with the existence of the enlarging of the bowel ,the wall thickening ,the misty margin ,the fat stranding ,the focalization of the le‐sions ,and the enlargement of nodes .The detection rate of CT increased when the enlarged bowel evolved into mass . There was a positive correlation between the misty margin and the T‐stage ,the enlarging of the bowel ,the wall thickening and the fat stranding .Conclusion CT can demonstrate most colon carcinomas even ther

关 键 词：结肠肿瘤 体层摄影术 X 线计算机 肠道准备 

分 类 号：R735.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]