CT增强扫描对结肠癌周围淋巴结转移的评估价值  

Evaluation Value of Contrast-Enhanced CT Scanning in Assessing Pericolic Lymph Node Metastasis of Colon Cancer

作　　者：张丽微[1] ZHANG Li-wei(Department of Radiology,Tianjin Xiqing Hospital.Tianjin 300380)

机构地区：[1]天津市西青医院放射科,天津300380

出　　处：《中国肛肠病杂志》2025年第3期6-8,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨分析CT增强扫描对结肠癌周围淋巴结转移的评估价值。方法:选择2019年1月到2024年3月,本院收治的62例结肠癌患者,所有患者均行CT增强扫描,记录CT征象特征与不同扫描时期的CT值。检查后均行手术治疗,并以手术结果作为判断淋巴结转移的金标准。根据是否发生淋巴结转移分为转移组22例和非转移组40例,比较2组CT征象及准确性。结果:62例患者中,术中发现周围淋巴结转移22例,其中2级16例,3级6例,占35.48%。转移组的肠壁增厚、肠腔狭窄、脂肪间隙模糊、肠腔液气平面等CT征象占比分别为90.91%、77.27%、90.91%、95.45%,显著高于非转移组的55.00%、40.00%、50.00%、45.00%(P<0.05)。转移组动脉期、门脉期、平衡期的CT值均低于非转移组(P<0.05)。CT增强扫描判断淋巴结转移1级42例,2级15例,3级5例,评估总准确性为91.94%,对淋巴结转移1级、2级、3级评估准确性分别为97.50%、81.25%和83.33%。结论:结肠癌发生周围淋巴结转移多伴随有CT征象异常与CT值降低,CT增强扫描对结肠癌周围淋巴结转移的评估价值较高。Objective To investigate and evaluate the diagnostic value of contrast-enhanced CT scanning in assessing pericolic lymph node metastasis in colon cancer.Methods A total of 62 colon cancer patients admitted to our hospital from January 2019 to March 2024 were enrolled.All patients underwent contrast-enhanced CT scans,and CT imaging features as well as CT values in different scanning phases were recorded.Surgical intervention was performed after examination,with surgical findings serving as the gold standard for lymph node metastasis.Patients were divided into the metastasis group(22 cases)and the non-metastasis group(40 cases)based on the presence of lymph node metastasis.CT features and diagnostic accuracy were compared between the two groups.Results Among the 62 patients,total 22 cases(35.48%)were confirmed with pericolic lymph node metastasis during surgery,including 16 cases of grade 2 and 6 cases of grade 3.The metastasis group showed significantly higher proportions of CT features such as intestinal wall thickening(90.91%),intestinal lumen narrowing(77.27%),fat space blurring(90.91%),and air-fluid levels(95.45%)compared to the non-metastasis group(55.00%,40.00%,50.00%,and 45.00%,respectively;P<0.05).The CT values in arterial,portal,and equilibrium phases were lower in the metastasis group than in the non-metastasis group(P<0.05).Contrast-enhanced CT scanning identified 42 cases of grade 1,15 cases of grade 2,and 5 cases of grade 3 lymph node metastasis,with an overall diagnostic accuracy of 91.94%.The accuracy rates for grades 1,2,and 3 lymph node metastasis were 97.50%,81.25%,and 83.33%,respectively.Conclusion Pericolic lymph node metastasis in colon cancer is often accompanied by abnormal CT imaging features and reduced CT values.Contrast-enhanced CT scanning demonstrates high diagnostic value in evaluating pericolic lymph node metastasis.

关 键 词：结肠癌 CT增强扫描 淋巴结转移 诊断价值 

分 类 号：R735.3[医药卫生—肿瘤]