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目的 探讨螺旋CT(SCT)对结、直肠癌术前分期的价值。方法 5 1例疑诊结、直肠肿瘤的患者行SCT扫描 ,扫描前清洁肠道 ,并经直肠注气 ,扫描范围从膈顶至耻骨联合。 5 1例中 ,41例经结肠镜或手术病理证实为结、直肠癌 (含腺瘤恶变 2例 ) ,其中 31例有手术、SCT等完整资料参与分期研究 ,将影像诊断结果与手术病理结果进行对照。结果 SCT总的分期准确率为 5 8.1% (18/ 31)。判断T分期的准确率为 84.4% (2 7/ 32 ) ,N分期的准确率为 6 1.3% (19/ 31)。评价肿瘤浆膜外侵犯的敏感性和特异性分别为 92 .9%和 5 0 .0 %。判断淋巴结转移的敏感性和特异性分别为 70 .0 %和 81.8%。结论 SCT扫描对结、直肠癌的术前分期有重要价值 ,有助于判断肿瘤浆膜外侵犯及区域淋巴结和远处转移情况。
Objective To investigate the value of spiral CT (SCT) in preoperative staging of colorectal cancer. Method 5 One patient with suspected knot and rectal tumor underwent an SCT scan. The intestine was cleaned before the scan and rectal gas was injected. The scope of the scan ranged from the diaphragm top to the pubic symphysis. Among the 51 cases, 41 cases were confirmed by colonoscopy or surgical pathology, and the rectal cancer (including 2 cases of malignant adenoma), of which 31 cases had complete data of surgery and SCT involved in the staging study. The diagnostic results of imaging and pathological findings For comparison. Results The overall staging accuracy of SCT was 5 8.1% (18/31). The accuracy of T staging was 84.4% (27/32), and the accuracy of N staging was 6 1.3% (19/31). The sensitivity and specificity of evaluating extravasular invasion of tumors were 92.9% and 50.0%, respectively. Sensitivity and specificity for determining lymph node metastasis were 70.0% and 81.8%, respectively. Conclusion The SCT scan has important value in the preoperative staging of colorectal cancer and rectal cancer, which is helpful to determine the extravasular invasion of the tumor and regional lymph nodes and distant metastasis.