术前256层螺旋CT双低剂量扫描对结肠癌肿瘤侵犯及肠系膜血管分布的评估价值  

Assessment value of preoperative 256-slice spiral CT double-low-dose scan in the tumor invasion and the distribution of mesenteric blood vessels of colon cancer

作　　者：宣建新[1] 刘哲峰[1] 滕伟[1] 李唯[1] 蔡淑云[2] XUAN Jian-xin;LIU Zhe-feng;TENG Wei(Department of Radiology,Chengde Central Hospital,Chengde 067000,China;不详)

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]承德市中心医院甲乳直肠外科,河北承德067000

出　　处：《中国医学装备》2023年第6期47-52,共6页China Medical Equipment

基　　金：河北省卫生健康委员会科研项目(20211799)“256层螺旋CT在直肠癌术前肠系解剖分析”;承德市科学技术科研项目(201904A011)“256层螺旋CT双低剂量在结肠癌腹腔镜术前评估中的应用”。

摘　　要：目的:探究术前256层螺旋CT双低剂量扫描对结肠癌肿瘤侵犯及肠系膜血管分布的评估价值。方法:选取在医院拟行腹腔镜结肠癌根治术的140例患者,采用随机数表法分为双低剂量组与常规剂量组,每组70例。双低剂量组与常规剂量组术前分别行256层螺旋CT双低剂量、常规剂量扫描。比较两组图像质量客观及主观评价、辐射剂量,以术后病理组织学诊断结果为“金标准”,分析常规剂量、双低剂量CT评估结肠癌肿瘤侵犯及肠系膜血管分布的准确率。结果:双低剂量组信噪比(SNR)、对比度噪声比(CNR)、噪声、CT值均低于常规剂量组,差异有统计学意义(t=14.415,t=16.045,t=2.163,t=30.096;P<0.05);2名医师对双低剂量组图像质量评分略低于常规剂量组,但两组间无明显统计学差异;双低剂量组剂量长度乘积(DLP)、容积CT剂量指数(CTDIvol)、有效剂量(ED)均低于常规剂量组,差异有统计学意义(t=20.227,t=21.355,t=24.207;P<0.05);双低剂量CT评估淋巴结转移、脉管侵犯、神经侵犯的准确率[(86.21%(25/29)和85.71%(18/21)和94.44%(17/18)]与术后病理比较,差异无统计学意义;双低剂量CT评估肠系膜上静脉组织、动脉分布于肠系膜上静脉背侧、动脉分布于肠系膜上静脉腹侧的准确率分别为98.57%(68/70)、90.32(28/31)和94.59%(35/37)与术后病理比较,差异无统计学意义。结论:结肠癌术前256层螺旋CT双低剂量扫描能提高图像质量,在降低辐射剂量及图像噪声方面具有明显优势,且能够准确评估结肠癌术前肿瘤侵犯及肠系膜血管的分布情况。Objective:To explore the assessment value of preoperative 256-slice spiral computed tomography(CT)double low-dose scanning in assessing the tumor invasion and the distribution of mesenteric blood vessels of colon cancer.Methods:A total of 140 patients who were scheduled to undergo laparoscopic radical resection of colon cancer in Chengde Central Hospital were selected and they were divided into a double-low-dose group and a conventionaldose group by random number table method,with 70 cases in each group.Both the double-low-dose group and the conventional-dose group underwent 256-slice spiral CT double-low-dose and conventional-dose scans before operation.The objective and subjective evaluations of image qualities and radiation dose were compared between the two groups,and the diagnostic results of postoperative histopathology were used as the"gold standard"to analyze the accuracies of conventional dose CT and double-low-dose CT in assessing the tumor invasion and the distribution of mesenteric blood vessel of colon cancer.Results:The signal to noise ratio(SNR),contrast to noise ratio(CNR),noise and CT values of the double-low-dose group were significantly lower than those of the conventional dose group(t=14.415,t=16.045,t=2.163,t=30.096,P<0.05),respectively.The image quality scores of 2 physicians in the double-low-dose group were slightly lower than those in the conventional dose group,but there was no significant difference between the two groups.The dose length product(DLP),computed tomography dose index(CTDIvol)and the effective dose(ED)in the double-lowdose group were significantly lower than those in the conventional-dose group(t=20.227,t=21.355,t=24.207,P<0.05),respectively.The accuracies of double-low-dose CT in assessing lymph node metastasis,vascular invasion,and nerve invasion[86.21%(25/29),85.71%(18/21),94.44%(17/18)]were not significantly different with those of postoperative pathology,respectively.The accuracies of double-low-dose CT in assessing the tissue of superior mesenteric vein,arterial distr

关 键 词：结肠癌 256层螺旋CT 低剂量 肿瘤侵犯 肠系膜血管分布 

分 类 号：R816.5[医药卫生—放射医学] R735.35[医药卫生—临床医学]