多层螺旋CT增强扫描诊断结直肠癌肺转移的相关因素分析  

Diagnostic Value of Enhanced Multislice Spiral and Risk Factor Analysis CT in Pulmonary Metastasis of Colorectal Cancer

作　　者：尤云峰[1] 程鸿琦 周一帆[1] 朱露林[1] 朱广伟[2] YOU Yun-feng;CHENG Hong-qi;ZHOU Yi-fan;ZHU Lu-lin;ZHU Guang-wei(Department of Radiology,910 Hospital of Joint Service Support Force of the People's Liberation Army,Quanzhou 362000,Fujian Province,China;Department of General Surgery,the First Affiliated Hospital of Fujian Medical University,Fuzhou 361000,Fujian Province,China)

机构地区：[1]中国人民解放军联勤保障部队910医院放射诊断科,福建泉州362000 [2]福建医科大学附属第一医院普外科,福建福州361000

出　　处：《中国CT和MRI杂志》2024年第8期39-41,共3页Chinese Journal of CT and MRI

基　　金：2022年福建省医学创新课题(2022CXA024)。

摘　　要：目的研究多层螺旋CT(MSCT)增强扫描技术在结直肠癌肺转移中的诊断价值,并对肺转移的危险因素进行分析。方法入选2019年1月至2022年2月于我院就诊的结直肠癌患者223例为研究对象,比较X线、MSCT对结直肠癌肺转移的诊断效能。根据活检结果将患者分为转移组和对照组,比较两组患者的临床资料,对影响结直肠癌肺转移的危险因素进行多元Logistic回归分析。结果在评价结直肠癌肺转移的诊断效能指标中,MSCT的准确度更高,且灵敏度、特异度以及阳性和阴性预测值均高于X线,结果具有统计学差异(P<0.05)。38例肺转移患者中11例(28.95%)病灶数目≥3个,MSCT图像中绝大多数病灶为实性结节,68.35%病灶边缘不光整,81.01%的病灶分叶,54.43%的病灶出现短毛刺,82.28%的病灶呈不均匀强化,长毛刺病灶比例较低,为26.58%。多元Logistic回归分析提示癌胚抗原表达升高、肿瘤原发于直肠以及Dukes C期为导致结直肠癌肺转移的独立危险因素。结论MSCT对结直肠癌肺转移的诊断价值较高,影像表现多样化,肿瘤原发部位为直肠、癌胚抗原表达升高及Dukes C期是结直肠癌肺转移的独立危险因素,对此类患者行MSCT增强扫描具有一定的意义。Objective To investigate the diagnostic value of multi-slice spiral CT enhanced scanning technique for lung metastasis of colorectal cancer,and to analyze the risk factors of lung metastasis.Methods 223 patients with colorectal cancer who visited our hospital from January 2019 to February 2022 were enrolled as the study subjects to compare the diagnostic efficacy of X-ray and MSCT for lung metastasis of colorectal cancer.According to the different biopsy results,patients were divided into two groups,metastasis group and control group,and the clinical data between the two groups were analyzed and compared.Multiple logistic regression was used to analyze the risk factors affecting the lung metastasis of colorectal cancer.Results In the evaluation of the diagnostic indicators of colorectal cancer lung metastasis,MSCT has higher accuracy,and the sensitivity,specificity,positive and negative predictive values are higher than those of X-ray,with statistical differences(P<0.05).11 of the 38 patients(28.95%)with lung metastases had≥3 lesions,the vast majority of lesions in MSCT images were solid nodules,68.35%had uneven margins,81.01%had lobulated lesions,54.43%had short burrs,82.28%had heterogeneous enhancement,and the proportion of long burr lesions was low,26.58%.Multiple logistic regression analysis suggested that the tumor originated from the rectum,elevated carcinoembryonic antigen expression as well as Dukes'C stage were independent risk factors for lung metastasis of colorectal cancer.Conclusion MSCT is of high value in the diagnosis of lung metastasis of colorectal cancer,with diverse imaging findings,and the primary site of the tumor is the rectum,elevated carcinoembryonic antigen expression and Dukes'C stage are independent risk factors for lung metastasis of colorectal cancer,contrast-enhanced MSCT scanning has certain significance for such patients.

关 键 词：多层螺旋CT 结直肠癌 肺转移 诊断价值 危险因素 

分 类 号：R735.37[医药卫生—肿瘤]