摘要
目的评估薄层CT预测直肠癌直肠筋膜受累的准确程度。方法术前活检病理证实的直肠癌60例,用薄层CT扫描,利用工作站Invert后处理功能,肉眼观察脂肪间隔以及用电子标尺测量脂肪间距两种方法,评估肿瘤直肠筋膜是否受累,并记录肿瘤位置。所有病例均行全直肠系膜切除术(TME),采用连续病理切片法观察手术标本,对照术前CT和术后病理结果,评估CT能否准确预测直肠癌CRM。结果方法一准确预测CRM 54例,敏感度(54/60)90%、特异度(14/18)78%、准确率(40/42)95%、PPV(14/16)88%、NPV(40/44)91%。(Kappa值为0.754,P<0.001)。方法二准确预测CRM 53例,敏感度(53/60)88%、特异度(13/18)72%、准确率(40/42)95%、PPV(13/15)87%、NPV(40/45)89%。(Kappa值为0.767,P<0.001)。两种方法经卡方检验P>0.05无统计学意义。结论术前薄层CT能准确预测直肠癌临近直肠筋膜的受累情况,为临床治疗方案的制订提供可靠依据。
Objective To evaluate the accuracy of preoperative thin-layer CT in prediction of involvement of rectal fascia in rectal cancer. Methods Sixty patients for biopsy-proven rectal cancer were assessed prospectively using thin-layer CT for involvement of rectal fascia and location of tumor was recorded. Preoperative CT assessment of these prognostic factors was compared with the histopathological findings in carefully matched whole-mount sections of the specimen. Results CT correctly evaluated the tumor in 54 patients, overstated in 2, and undervalued in 2. The accuracy of evaluation was 95% （40/42）. Sensitivity was 90%（54/60）, specificity was 78% （14/18）, Kappa=0. 754, （ P 〉0.05）. Conclusion Preoperative thin-layer CT does produce reliable prediction of clear CRM and provide reliable basis for clinic to work out therapeutic regimen.
出处
《医学影像学杂志》
2013年第10期1588-1591,1596,共5页
Journal of Medical Imaging
