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目的探讨低张水灌肠多层螺旋CT(MSCT)动态增强扫描对大肠癌分期的诊断价值。方法对60例内镜诊断或怀疑大肠癌的患者行MSCT动态3期增强扫描,以横断面图像为基础,结合多平面重组(MPR),进行TNM分期,与术后病理对照。结果53例大肠癌有分期研究价值。MSCT检出了全部大肠癌,敏感度为100%,对大肠癌TNM分期的准确度为83.0%(44/53),其中T分期准确度为94.3%(50/53),N分期的准确度为86.8%(46/53),M分期的准确度为98.1%(52/53)。结论MSCT可以有效地显示大肠癌的部位、大小和形态,能较准确地确定中晚期大肠癌的侵犯范围和肝脏转移,TNM分期准确度较普通螺旋CT有明显提高;增强门脉期或平衡期对TNM分期准确度差异无统计学意义。
Objective To investigate the value of dynamic contrast-enhanced multi-slice spiral CT (MSCT) scan in the diagnosis of colorectal cancer staging. Methods Sixty patients with endoscopic diagnosis or suspected colorectal cancer underwent MSCT dynamic three-phase enhancement scan. The images were based on cross-sectional images and combined with multiplanar reformation (MPR). The TNM staging was compared with postoperative pathology. Results 53 cases of colorectal cancer have staging research value. All colorectal cancers were detected by MSCT with a sensitivity of 100% and an accuracy of 83.0% (44/53) for colorectal cancer TNM staging. The accuracy of T staging was 94.3% (50/53), and the accuracy of N staging. It is 86.8% (46/53). The accuracy of M-phase is 98.1% (52/53). Conclusion MSCT can effectively display the location, size and shape of colorectal cancer, and can accurately determine the extent of invasion of middle and late colorectal cancer and liver metastases. The accuracy of TNM staging is significantly improved compared with ordinary spiral CT; enhanced portal vein phase or balance phase There was no significant difference in the accuracy of TNM staging.