摘要
目的 探讨彩色多普勒血流显像对直肠癌Miles术后局部复发灶的诊断价值。方法 应用彩色多普勒血流显像仪经会阴和骶部检查直肠癌Miles术后骶前肿物患者 5 1例 ,分析肿块内血流程度及血流动力学定量指标 :收缩期峰值速度 (peaksystolicvelocity,PSV) ,舒张末期速度 (enddias tolicvelocity ,EDV) ,阻力指数 (resistiveindex ,RI) ,搏动指数 (pulsatilityindex ,PI)。结果 术后复发肿物血流信号以Ⅱ -Ⅲ为主 ,占 81 82 % (2 7/ 33) ;良性病变以 0 -Ⅰ级为主 ,Ⅱ -Ⅲ级血流信号占2 7 78% (5 / 18)。二者比较差异有显著性 (χ2 =14 5 5 ,P <0 0 1)。术后复发肿块血流动力学特征 :低PSV、低PI、低RI、高EDV。良、恶性病变四项指标间差异有显著性。结论 对CT发现直肠癌Miles术后骶前肿物患者可行会阴和骶部彩色多普勒检查 ,分析肿块内血流情况 ,鉴别良恶性 ,有助于提高术后局部复发的诊断率。
Objective To evaluate color Doppler sonography in the diagnosis of local recurrence in patients undergoing Miles procedure for rectal carcinoma.[WT5”HZ] Methods Transperineal and transsacral color Doppler blood flow sonography was performed on 51 patients presenting presacral masses after Miles procedure for rectal carcinoma. Blood flow richness and the blood flow dynamics indexes e.g. peak systolic velocity (PSV), diastolic velocity (EDV),resistive index (RI), and pulsatility indexs (PI) were recorded and analyzed. Results Blood flow signals in the recurrent masses were mainly Ⅱ-Ⅲ amounting to 81 82% (27/33), and that of benign masses were mainly 0-Ⅰ,Ⅱ-Ⅲ amounting to 27 78% (5/18). Both were significantly different (χ 2=14 55, P <0 01).Blood flow dynamic characteristics of recurrent masses were low PSV,low PI, low RI and high EDV.All four variables were significantly different between the malignant and benign masses.Conclusion For presacral masses of Miles’ postoperative rectal carcinoma detected by CT, transperineal color Doppler sonography could be applied to differentiate malignant from benign masses by means of observing blood flow signals. This helps in raising the diagnostic rate of recurrence in postoperative rectal carcinoma patients.
出处
《中华普通外科杂志》
CSCD
2000年第11期657-658,共2页
Chinese Journal of General Surgery
