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目的：探讨结肠癌术后复发的钡灌肠与ＣＴ诊断。材料与方法：７５例结肠癌，有４３例术后复发（５７％），２８％局部复发同时合并远处转移，２３％单纯远处转移。术后１～２年局部复发者为５７％（１２／２１），远处转移者为６３％（１４／２２）。ＣＴ扫描层厚和层间距均为８ｍｍ，吻合口部位加作薄层扫描。结肠双重造影用７０％Ｗ／Ｖ混悬钡液。结果：结肠癌术后复发的主要ＣＴ表现：５例可见吻合口区肠腔内不规则软组织结节影；９例见吻合口周围或骶骨前方不规则软组织块影；３例肿块中央见低密度坏死区；１例伴有斑片状及点状钙化灶。此外尚有肠壁增厚，边缘不规则以及相邻组织器官受侵犯。术后远处转移常见部位为肝脏。结肠双重造影主要表现为吻合口偏心性或不规则性狭窄；吻合口区充盈缺损，邻近的肿块效应或“双边征”。结论：钡灌肠对吻合口和肠腔内的复发检查敏感，且较准确；而ＣＴ对检查结肠癌术后复发的位置、大小、范围、腔外肿块或远处转移均敏感。ＣＴ与钡灌肠检查相结合，能最大限度地发现结肠癌术后复发。术后４个月基础ＣＴ扫描及术后基础钡灌肠检查有利于在术后正常改变过程中检出更小的复发灶。
Objective: To explore the diagnosis of colon resection after rectal enuresis and CT. Materials and Methods: In 75 cases of colon cancer, there were 43 cases of postoperative recurrence (57%), 28% of local recurrence combined with distant metastasis, and 23% of distant metastasis. Local recurrence was 15% (12/21) in patients 1 to 2 years after surgery, and 63% (14/22) in distant metastases. CT scan thickness and layer spacing were 8mm, and the anastomosis site was scanned with thin layer. Colonic double contrast with 70% W/V suspended sputum. Results: The main CT manifestations of colon cancer recurrence after resection: irregular soft tissue nodules were found in the anastomosis in 5 cases; irregular soft tissue masses were found in 9 cases around the anastomosis or in front of the sacrum; low density was seen in the middle of the mass in 3 cases. Necrosis area; 1 case with patchy and punctate calcification. In addition, there are thickening of the intestinal wall, irregular edges and violations of adjacent tissues and organs. The common site of distant metastasis after surgery is the liver. Double-contrast colonography is mainly characterized by anastomotic or irregular stenosis of the anastomosis; anastomotic filling defect, adjacent mass effect or “bilateral sign”. Conclusion: Barium enema is sensitive to the recurrence of anastomotic and intestinal cavities, and CT is more accurate; and CT is sensitive to the location, size, range, extraluminal mass or distant metastasis of colon cancer after recurrence. The combination of CT and barium enema examination can maximize the detection of recurrence of colon cancer. Fundamental CT scan and postoperative postoperative barium enema after 4 months postoperatively facilitated the detection of smaller recurrent foci during normal postoperative changes.