摘要
目的:探讨多层螺旋CT多期增强扫描对原发性结直肠黏液腺癌的诊断价值。方法:收集2018年1月至2023年1月收治的68例病理检查确诊为原发性结直肠黏液腺癌患者资料,患者术前均接受多层螺旋CT多期增强扫描检查,以术后病理结果为金标准,分析多层螺旋CT多期增强扫描对原发性结直肠黏液腺癌的诊断价值,并总结其影像学表现。结果:多层螺旋CT多期增强扫描诊断原发性结直肠黏液腺癌的灵敏度(96.9%)、阳性预测值(98.4%)、诊断符合率(92.7%)较高,但特异度(50.0%)、阴性预测值(20.0%)较低。多层螺旋CT多期增强扫描评估原发性结直肠黏液腺癌患者TNM分期与术后病理学检查结果的一致性均较高,Kappa值分别为0.780、0.755、1.000。68例患者影像学表现,病灶部位:升结肠11例,横结肠9例,降结肠5例,乙状结肠14例,直肠29例;强化形式:轻度强化41例,中度强化17例,重度强化10例;增厚形式:环形均匀增厚16例,环形不均匀增厚38例,偏心增厚9例,局部肿块样增厚5例;钙化10例;肠梗阻6例;肛周侵犯:轻度侵犯35例,中度侵犯23例,重度侵犯10例;增强后低密度区:少量13例,中量29例,大量26例;淋巴结转移26例;远处转移2例。结论:多层螺旋CT多期增强扫描对原发性结直肠黏液腺癌具有较高诊断价值,当多层螺旋CT表现为病灶轻中度强化、肠壁大范围环形增厚、伴钙化、可见低密度区及淋巴结转移时,应考虑为原发性结直肠黏液腺癌。
Objective To evaluate the value of multiphase enhanced multislice spiral CT(MSCT)in the diagnosis of primary colorectal mucinous adenocarcinoma.MethodsThe data of total 68 patients with primary colorectal mucinous adenocarcinoma diagnosed by pathological examination were collected from January 2018 to January 2023.All patients were examined by multiphase enhanced MSCT before surgery.The diagnostic value of multiphase enhanced MSCT in primary colorectal mucinous adenocarcinoma was analyzed,using postoperative pathological results as the gold standard,and the imaging findings were summarized.Results The sensitivity(96.9%),positive predictive value(98.4%)and diagnostic coincidence rate(92.7%)of multiphase enhanced MSCT in the diagnosis of primary colorectal mucinous adenocarcinoma were high,but the specificity(50.0%)and negative predictive value(20.0%)were low.The TNM staging of patients with primary colorectal mucinous adenocarcinoma assessed by multiphase enhanced MSCT was highly consistent with the results of postoperative pathological examination,with Kappa values of 0.780,0.755 and 1.000,respectively.The imaging findings of the disease location in total 68 patients were as follows:ascending colon(1l cases),transverse colon(9 cases),descending colon(5 cases),sigmoid colon(14 cases)and rectum(29 cases).Methods of enhancement:41 cases were mild enhancement,17 cases were moderate enhancement and 10 cases were severe enhancement.The types of thickening were:annular and even thickening in 16 cases,annular and uneven thickening in 38 cases,eccentric thickening in 9 cases and local lump-like thickening in 5 cases.Calcification appeared in 1o cases.Intestinal obstruction occurred in 6 cases.Perianal invasion:35 cases of mild invasion,23 cases of moderate invasion,and 10 cases of severe invasion.Low density region after enhancement:there were a small amount of low density region in 13 cases,a moderate amount in 29 cases and a large amount in 26 cases.Lymph node metastasis occurred in 26 cases and distant metastasis appea
作者
陈琪璇
黄文起
董备
CHEN Qi-xuan;HUANG Wen-qi;DONG Bei(Shangqiu First People's Hospital,Shangqiu,Henan 476000)
出处
《中国肛肠病杂志》
2023年第11期34-37,共4页
Chinese Journal of Coloproctology
关键词
多层螺旋CT
多期增强扫描
原发性结直肠黏液腺癌
诊断
Multislice spiral CT
Multiphase enhanced scanning
Primary colorectal mucinous adenocar-cinoma
Diagnosis
