结肠癌CT漏诊原因分析  

Analysis of CT missed diagnosis of colon cancer

作　　者：陈炯[1] 黄玲芳[2] 黄兴旺 李俊 丁可[1] CHEN Jiong;HUANG Lingfang;HUANG Xingwang;LI Jun;DIGN Ke(Department of Radiology,the Second People's Hospital of Nanning,Nanning 530031,China;Guangri Vocational and Technical College of Health,Nanning 530021,China)

机构地区：[1]南宁市第二人民医院放射科,广西南宁530031 [2]广西卫生职业技术学院,广西南宁530021

出　　处：《实用放射学杂志》2022年第11期1811-1814,共4页Journal of Practical Radiology

摘　　要：目的分析结肠癌的CT漏诊原因.方法回顾性分析行CT增强检查结肠癌漏诊19例患者的资料,最终均经活检或手术病理明确诊断,分析其漏诊原因.结果19例患者中,右半结肠癌6例,左半结肠癌13例.7例病灶小而扁平且仅占部分环壁;3例被水肿的肠管掩盖;2例多发结肠癌;4例多原发癌,2例未做肠道准备;1例误认为贲门;2例未多平面观察;无肠梗阻症状及影像表现15例,有症状但CT检查时无肠梗阻表现3例,有肠梗阻症状及CT表现1例.结论结肠癌CT漏诊的主要原因是病灶扁平、肠壁水肿掩盖、CT检查时无肠梗阻、放射科医生未意识到多原发癌及多发结肠癌;注意扁平病灶及移行带,警惕多原发癌、多发结肠癌,可有效降低结肠癌的漏诊率.Objective To analyze the causes of missed diagnosis of colon cancer by CT.Methods The data of 19 cases of missed diagnosis of colon cancer by CT enhancement examination were analyzed retrospectively,all of which were diagnosed through biopsy or surgical pathology,and the reasons for missed diagnosis were analyzed.Results There were 6 cases with right colon cancer and 13 cases with left colon cancer among 19 patients.The lesions of 7 cases were small and flat in shape,and only located in partial ring wall;the lesions of 3 cases were covered by intestinal wall edema;2 cases had multiple colon cancers and 4 cases had multiple primary cancers;2 cases did not make the bowel preparation;the lesion of 1 case was misdiagnosed as cardia of stomach;multi-plane observation was not performed in 2 cases.No ileus symptom and imaging manifestation in 15 cases,positive symptoms but without corresponding CT manifestations in 3 cases,and positive symptom with corresponding CT manifestations in 1 cases were found.Conclusion The main reason for CT missed diagnosis of colon cancer is include flat focus,cancer focus covered by intestinal tube edema,no obstruction in CT examination,radiologists unawareness of multiple primary cancer and multiple colon cancer.The missed diagnosis rate of colon cancer can be reduced effectively by paying attention to flat focuses and transition zone,staying aware of multiple primary cancer and multiple colon cancer.

关 键 词：结肠癌 漏诊 计算机体层成像 

分 类 号：R735.35[医药卫生—肿瘤] R814.42[医药卫生—临床医学]