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目的探讨直肠充气CT扫描在直肠癌术前诊断中的临床应用价值。资料与方法分析经手术病理证实的67例直肠癌患者直肠充气CT扫描的表现,比较CT分期和病理分期的符合率。结果67例直肠癌的CT诊断准确率为100%;诊断直肠癌侵犯浆膜外脂肪的阳性预测值、阴性预测值、敏感性、特异性、假阳性率、假阴性率分别为93.2%、75%、96.5%、60%、40%、3.5%;诊断盆腔区域淋巴结转移的阳性预测值、阴性预测值、敏感性、特异性、假阳性率、假阴性率分别为74.2%、69.4%、67.6%、75.8%、24.2%、32.4%;CT分期和病理分期Ⅰ～Ⅲ期的符合率分别为75%、60.7%、74.2%,总符合率为68.7%。结论直肠充气CT扫描能较准确地检出直肠癌和显示浆膜外脂肪的侵犯;但对直肠癌的分期和淋巴结转移的判定仍有一定的局限性。
Objective To investigate the clinical value of rectal inflation CT in preoperative diagnosis of rectal cancer. Materials and Methods 74 cases of rectal cancer confirmed by surgery and pathology were retrospectively analyzed. The coincidence rates of CT staging and pathological staging were compared. Results The accuracy of CT diagnosis in 67 cases of rectal cancer was 100%. The positive predictive value, negative predictive value, sensitivity, specificity, false positive rate and false negative rate in diagnosis of rectal cancer with extravasular fat were 93.2%, 75 The positive predictive value, negative predictive value, sensitivity, specificity, false positive rate and false negative rate were 74.2%, 69.4%, 67.6% respectively, which were respectively 96.5%, 60%, 40% and 3.5% %, 75.8%, 24.2%, 32.4%. The coincidence rates of CT staging and pathological staging Ⅰ ~ Ⅲ were 75%, 60.7% and 74.2%, respectively. The total coincidence rate was 68.7%. Conclusions The rectal inflation CT scan can detect the rectal cancer more accurately and show the extravasular fat invasion. However, there are still some limitations in judging the staging and lymph node metastasis of rectal cancer.