双能量CT对结直肠癌术前分期的评价  

Evaluation of preoperative staging of colorectal cancer diagnosed by dual-energy computed tomograph

作　　者：张晓斌[1] 徐慧慧 冯长明 霍英杰[2] ZHANG Xiaobin;XU Huihui;FENG Changming(Maternal-Child Health Center of Langfang City,Hebei,Langfang 065000,China)

机构地区：[1]河北省廊坊市妇幼保健中心,065000 [2]中国石油天然气集团公司中心医院

出　　处：《河北医药》2018年第6期890-893,897,共5页Hebei Medical Journal

基　　金：项目来源:廊坊市科学技术研究与发展计划项目(编号2014013011C)

摘　　要：目的探讨结肠充气双能量CT(Dual-energy computed tomograph,DSCT)对结直肠癌术前分期的诊断价值。方法选取经病理证实的结直肠癌患者41例,所有患者术前均行结肠充气DSCT平扫及增强扫描,评价肿瘤的部位、大小、侵犯范围(T)、淋巴结转移(N)及远处转移(M)情况,做出诊断及TNM分期,并与术后病理对照,评价准确性、灵敏度及特异度。结果 DSCT检出了全部41例结直肠癌。T、N、M分期准确性分别为90.2%(37/41)、60.9%(25/41)、100%(41/41)。T2、T3、T4期灵敏度分别为83.3%、92.3%、93.8%,特异度分别为100%、96.4%、88%。N0、N1、N2期灵敏度分别为81.8%、62.5%、64.7%,特异度分别为75.0%、92.9%、83.3%。远处转移的患者无漏诊。结论 DSCT能够准确地分析结直肠癌的浸润深度、有无临近转移性淋巴结及远处转移,是一种有实用价值的术前分期方法。Objective To investigate the diagnostic value of dual-energy computed tomograph(DSCT)in preoper ative staging of colorectal cancer.Methods Forty-one patients with colorectal cancer who were pathologically confirmed in our hospital were enrolled in the study.All the patients underwent preoperative colon-enhanced DSCT and enhanced scanning examination to evaluate tumor location,size,extent of invasion(T),lymph node metastasis and distant metastasis(M)to obtain diagnosis and TNM staging.Moreover the examination results were compared with those by postoperative pathological examination to evaluate the accuracy,sensitivity and specificity.Results The 41 cases of colorectal cancers were detected by DSCT.The accuracy of T,N,M staging was 90.2%(37/41),60.9%(25/41)and 100%(41/41),respectively.The sensitivity of T2,T3 and T4 was 83.3%,92.3%and 93.8%,respectively,and the specificity was 100%,96.4%and 88%,respectively.Moreover the sensitivity of N0,N1 and N2 was 81.8%,62.5%,64.7%,respectively,and the specificity was 75.0%,92.9%,83.3%,respectively.In addition no patients with distant metastases were missed diagnosed.Conclusion DSCT can accurately analyze the invasion depth of colorectal cancer,the tumor with or without adjacent metastatic lymph nodes and distant metastases,therefor,which is a practical preoperative staging method.

关 键 词：双能量CT 术前分期 结直肠肿瘤 结肠充气 

分 类 号：R735.35[医药卫生—肿瘤]