256层螺旋CT双低剂量扫描在结肠癌患者腹腔镜术前评估中的应用研究  

Application of 256 slice spiral CT dual low-dose scanning in preoperative evaluation of colon cancer patients under laparoscopy

作　　者：李唯[1] 滕伟[1] 蔡淑云[2] 宣建新[1] 刘哲峰[1] 杜建文[3] LI Wei;TENG Wei;CAI Shu-yun(Department of Radiological Diagnosis,Chengde Central Hospital,Chengde Hebei 067000,China;Department of Tumor Anorectal,Chengde Central Hospital,Chengde Hebei 067000,China)

机构地区：[1]承德市中心医院放射医学诊断科,河北承德067000 [2]承德市中心医院肿瘤肛肠科,河北承德067000 [3]承德市中心医院超声科,河北承德067000

出　　处：《临床和实验医学杂志》2023年第3期314-318,共5页Journal of Clinical and Experimental Medicine

基　　金：承德市科学技术研究与发展计划项目(编号:201904A011);河北省医学科学研究课题计划项目(编号:20191301)。

摘　　要：目的探讨256层螺旋CT(MSCT)双低剂量扫描在结肠癌患者腹腔镜术前评估中的应用价值。方法回顾性选取2020年7月至2022年7月在承德市中心医院治疗的结肠癌患者114例,给予256层螺旋CT双低剂量、常规剂量扫描。分析双低剂量、常规剂量扫描与术后病理结果差异;比较双低剂量、常规剂量术前扫描中结肠壁/带、肿块图像质量;记录术前在两种模式下右半结肠癌患者右结肠动脉(RCA)与结肠中动脉(MCA)共干长、MCA干长和胃结肠静脉干(GTH)干长以及左半结肠癌患者肠系膜下动脉(IMA)根部至腹主动脉分叉点距离、IMA根部至其发生第一分支的距离;比较两种扫描模式的有效辐射剂量。结果术前MSCT双低剂量、常规剂量扫描T分期与术后病理T分期Kappa值分别为0.856和0.844。术前MSCT双低剂量、常规剂量扫描T分期准确率分别为89.47%和88.60%,差异无统计学意义(P>0.05)。术前MSCT双低剂量、常规剂量扫描N分期与术后病理N分期Kappa值分别为0.819和0.896。术前MSCT双低剂量、常规剂量扫描N分期准确率分别为89.47%和93.86%,差异无统计学意义(P>0.05)。术前MSCT双低剂量、常规剂量扫描中结肠壁/带、肿块图像质量比较,差异无统计学意义(P>0.05)。在右半结肠癌患者中,术前MSCT双低剂量、常规剂量扫描RCA与MCA共干长、MCA干长和GTH干长比较,差异无统计学意义(P>0.05);在左半结肠癌患者中,术前MSCT双低剂量、常规剂量扫描IMA根部至腹主动脉分叉点距离、IMA根部至其发生第一分支的距离比较差异无统计学意义(P>0.05)。MSCT双低剂量扫描有效辐射剂量为(11.03±1.19)mSv,明显低于MSCT常规剂量扫描[(21.05±1.60)mSv],差异有统计学意义(P<0.05)。结论256层螺旋CT双低剂量扫描可满足结肠癌患者腹腔镜术前评估需求,同时降低患者辐射剂量。Objective To investigate the value of 256 slice spiral CT(MSCT)dual low dose scanning in preoperative evaluation of colon cancer patients under laparoscopy.Methods A total of 114 patients with colon cancer who were treated in Chengde Central Hospital from July 2020 to July 2022 were retrospectively selected to receive 256 slice spiral CT dual low dose and conventional dose scanning.The differences between dual low dose and conventional dose scanning and postoperative pathological results were analyzed.The image quality of colon wall/band and mass was compared between the two groups before operation.The length of the right colon artery(RCA)and the middle colon artery(MCA)in the right colon cancer patients,the length of the MCA trunk and the length of the gastrocolic vein trunk(GTH)trunk,and the distance from the root of the inferior mesenteric artery(IMA)to the bifurcation point of the abdominal aorta and the distance from the root of the IMA to the first branch of the IMA in the left colon cancer patients before surgery are recorded in two modes.The effective radiation dose of two scanning modes was compared.Results The Kappa values of preoperative double low dose MSCT,conventional dose MSCT T staging and postoperative pathological T staging were 0.856 and 0.844,respectively,the accuracy of preoperative double low dose MSCT and conventional dose MSCT T staging was 89.47%and 88.60%,respectively,with no significant difference(P>0.05).The Kappa values of preoperative dual low dose MSCT,conventional dose MSCT scanning N staging and postoperative pathological N staging were 0.819 and 0.896,respectively.The accuracy of preoperative dual low dose MSCT and conventional dose MSCT scanning N staging was 89.47%and 93.86%,respectively,with no significant difference(P>0.05).There was no significant difference in image quality of colon wall/band and mass between double low dose and conventional dose MSCT scanning before operation(P>0.05).In patients with right colon cancer,there was no significant difference in the length of t

关 键 词：结肠癌 256层螺旋CT 双低剂量 常规剂量 腹腔镜 

分 类 号：R735.35[医药卫生—肿瘤]