结直肠癌多层螺旋CT影像学表现与临床病理类型的相关性分析  

Correlation Between MSCT Imaging Manifestations and Clinical Pathological Types of Colorectal Cancer

作　　者：成传立 王益[1] 赵端仪 吴瑞乔[1] CHENG Chuan-li;WANG Yi;ZHAO Duan-yi;WU Rui-qiao(Department of General Surgery,tianyou Hospital Affiliated to Wuhan University of Science and technology,Wuhan 430064,Hubei Province,China)

机构地区：[1]武汉科技大学附属天佑医院普外科,湖北武汉430064

出　　处：《中国CT和MRI杂志》2022年第6期151-152,161,共3页Chinese Journal of CT and MRI

基　　金：湖北省卫计委项目(WJ2017M193)。

摘　　要：目的分析结直肠癌MSCT影像学表现与临床病理类型的相关性。方法选取本院2017年2月至2019年5月收治的104例患者作为研究对象,对不同病理类型的结直肠癌形态、位置、密度、有无转移、与周围组织关系及平扫和增强扫描CT值等特征进行分析。结果黏液腺癌平扫、增强CT值均低于低分化腺癌和中高分化腺癌;低分化腺癌平扫、增强CT值低于中高分化腺癌;低分化腺癌与黏膜腺癌增强扫描多不均匀强化,周围脂肪密度以增高为主,血管增粗多见,其中黏膜腺癌淋巴结转移及肝、肺等远处脏器转移较少见。而低分化腺癌无肝、肺等远处脏器转移;中高分化腺癌增强扫描多均匀强化,周围脂肪密度增高、血管增粗、淋巴结转移及肝、肺等远处脏器转移较少见,三者平扫、增强CT值、周围脂肪密度、血管增粗及肿瘤强化形式比较,差异均有统计学意义(P<0.05);淋巴结转移及远处脏器转移出现率比较无明显差异(P>0.05)。结论MSCT可有效显示结直肠癌的影像学特点,不同病理类型的结直肠癌其CT征象各具特异性。平扫加增强扫描有助于判断结直肠癌的病理学类型。Objective To analyze the correlation between MSCT imaging manifestations and clinical pathological types of colorectal cancer.Methods 104 patients admitted to our hospital from February 2017 to May 2019 were selected as the research subjects.The shape,location,density,presence or absence of metastasis,relationship with surrounding tissues,and CT values of plain and enhanced scans were analyzed for different types of colorectal cancer.Results The CT values of mucinous adenocarcinoma in plain scan and enhanced scan are lower than those of poorly differentiated adenocarcinoma and middle-highly differentiated adenocarcinoma.The CT value of poorly differentiated adenocarcinomas in plain and enhanced scans is lower than that of middle-highly differentiated adenocarcinomas The enhanced scans of poorly differentiated adenocarcinoma and mucosal adenocarcinoma mostly show uneven enhancement.The density of peripheral fat is mainly increasing,and blood vessels become thicker,and lymph node metastasis of mucosal adenocarcinoma and distant organ metastases such as liver and lung are rare.Low-differentiated adenocarcinoma does not have distant organ metastases such as liver and lung.The enhanced scans of middle-highly differentiated adenocarcinomas usually show uniform enhancement.Increasing density of peripheral fat,thickening of blood vessels,lymph node metastasis,and distant organ metastases such as liver and lung are rare.There was a statistically significant difference between the three tumors in CT value of plain scan and enhanced scan,density of peripheral fat,vascular thickening and tumor enhancement(P<0.05).There was no significant difference in the incidence of lymph node metastasis and distant organ metastasis(P>0.05).Conclusion MSCT can effectively display the imaging characteristics of colorectal cancer,and the CT signs of colorectal cancer of different pathological types have their specificities.Its plain scan and enhanced scan can help determine the pathological type of colorectal cancer.

关 键 词：多层螺旋CT 结直肠癌 病理类型 影像学表现 

分 类 号：R445.3[医药卫生—影像医学与核医学] R735.37[医药卫生—诊断学]