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目的探讨脂肪对比剂灌肠多层螺旋CT(MSCT)对大肠癌分期的诊断价值。方法对33例内镜活检证实的大肠癌患者,扫描前充分肠道准备、肌注低张剂后,经直肠导管注入脂肪对比剂(CT值-200～-240HU)1500ml,行MSCT动态增强扫描,以横断面图像为基础,结合多平面重组(multiplanar reconstruction,MPR)及CT仿真内窥镜(CT virtual endoscopy,CTVE),进行TNM分期,并与术后病理对照。结果术前MSCT诊断大肠癌33例,TNM总分期准确度为78.78%(26/33),其中T分期敏感度为100%,阳性诊断准确度为87.88%(29/33);N分期敏感度为86.36%(19/22),阳性诊断准确度为68.18%(15/22)。5例肝脏转移的患者均被CT检查发现。结论脂肪对比剂多层螺旋CT对大肠癌分期有重要意义。
Objective To investigate the diagnostic value of fat contrast agent multi-slice spiral CT (MSCT) in the staging of colorectal cancer. Methods Thirty-three patients with colorectal cancer confirmed by endoscopic biopsy were enrolled in this study. Before intestine scan, intestinal preparations were prepared and intramuscular hypothyroidism was administered. 1500ml of fat contrast agent (CT value -200 ~ -240HU) The TNM staging was performed based on the cross-sectional images combined with multiplanar reconstruction (MPR) and CT virtual endoscopy (CTVE). Results Totally 33 cases of colorectal cancer were diagnosed by preoperative MSCT. The total TNM staging accuracy was 78.78% (26/33), of which T stage sensitivity was 100% and positive diagnosis accuracy was 87.88% (29/33). Staging N sensitivity 86.36% (19/22), positive diagnosis accuracy was 68.18% (15/22). Five patients with liver metastases were detected by CT. Conclusion Lipid contrast agent multi-slice spiral CT has important significance for the staging of colorectal cancer.