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目的:评估螺旋CT扫描(Spiral CT;SCT)对结直肠癌术前分期的诊断价值及限度。方法:对68例经结肠气钡双对比造影和电子结肠镜活检证实的结直肠癌病人,术前行螺旋CT扫描,进行螺旋CT术前TNM和Duke分期,然后与术中、术后病理各分期一一对照。结果:螺旋CT双期扫描显示结直肠癌的敏感性达98.5％(67/68);对结直肠癌TNM分期的准确率83.8％(57/68),Duke分期的准确率为86.7％(59/68),较文献报道的普通CT扫描的50％有明显提高。其中T分期,螺旋CT诊断的正确率为88.2％(60/68);N分期为83.8％(57/68),5例有肝转移的病人螺旋CT均正确诊断。结论:充分的扫描前肠管准备和良好的扫描方法是螺旋CT时结直肠癌准确分期的关键;螺旋CT扫描对结直肠癌术前分期很有价值,是目前临床评价结直肠癌术前分期的最有效检查方法之一;螺旋CT扫描时结直肠癌的T分期存在一定限度,对于微小淋巴结转移以及远处微小或潜在转移的诊断尚有一定困难。
Objective: To evaluate the value and limitation of Spiral CT (SCT) in preoperative staging of colorectal cancer. Methods: Sixty-eight patients with colorectal cancer confirmed by colon-barium dual contrast angiography and electronic colonoscopy biopsy underwent preoperative spiral CT scans and TNM and Duke staging before spiral CT, and then compared with postoperative pathology Staged one by one control. Results: The sensitivity of spiral CT was 98.5% (67/68) in two-phase scanning of colorectal cancer, 83.8% (57/68) in TNM staging of colorectal cancer, and 86.7% of Duke staging / 68), compared with 50% of the common CT scan reported in the literature. The accuracy of T stage and helical CT diagnosis was 88.2% (60/68). The N stage was 83.8% (57/68). All the 5 cases with liver metastases were correctly diagnosed by spiral CT. CONCLUSIONS: Adequate bowel preparation and good scanning before scanning are the key to the accurate staging of colorectal cancer on spiral CT. Spiral CT scanning is valuable for the preoperative staging of colorectal cancer and is currently the clinical evaluation of preoperative staging of colorectal cancer One of the most effective examination methods is that there is a certain limit to the T stage of colorectal cancer during spiral CT scan, and there is still some difficulty in the diagnosis of small lymph node metastasis and distant tiny or potential metastasis.