Revolution CT后处理技术在直肠癌术前分期中的应用

刘慧慧，李如刚，陈香远，范昕，蔡晓杰，张礼荣，王冬青，宋廉

（江苏大学附属医院影像科，江苏 镇江，212001）

浏览次数：118次 下载次数：541次

摘要：

目的 探讨Revolution CT 后处理技术在直肠癌术前分期中的应用价值。方法 回顾性分析我院32 例经临床手术证实的直肠癌患者的临床资料，所有患者均行256 排Revolution CT 平扫及增强检查，图像行多平面重组（MPR）、最大密度投影（MIP）、曲面重组（CPR）后处理，将影像学检查结果与术后病理TNM 分期进行比较。结果 与术后病理T 分期比较，术前CT-T 分期的灵敏度为100.00%（32/32），符合率为87.50%（28/32），与术后病理T 分期的一致性良好（Kappa=0.765）；术前CT-N 分 期灵敏度为93.75%（15/16），符合率为93.75%（30/32），与术后病理N 分期的一致性良好（Kappa=0.900）；术前CT-M 分期灵 敏度为100.00%（5/5），符合率为100.00%（32/32），与术后病理M 分期一致性较好（Kappa=1.000）。结论 Revolution CT 平扫、
增强及后处理的应用可有效显示直肠癌位置、大小和形态，确定肿瘤侵犯范围、有无淋巴结及远处转移等，可以准确进行术 前TNM 分期，对手术方案的制定有指导意义。

关键词：直肠癌；多层螺旋CT；诊断价值

中图分类号：R735.34；R730.44文献标志码：A文章编号：2096-1413(2017)34-0001-03

Application of revolution CT post-processing technique in preoperative staging of rectal cancer
LIU Hui-hui, LI Ru-gang, CHEN Xiang-yuan, FAN Xin, CAI Xiao-jie, ZHANG Li-rong, WANG Dong-qing, SONG Lian


(Department of Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, China)

ABSTRACT: Objective To evaluate the application value of revolution CT post -processing technique in preoperative staging of rectal cancer. Methods The clinical data of 32 rectal cancer patients confirmed by clinical operation in our hospital were retrospectively analyzed. All the patients underwent 256 rows of revolution CT plain scan and enhanced examination, and all the images were post-processed with multiplanar reconstruction (MPR), maximum intensity projection (MIP) and curve planar reconstruction (CPR), the results of images were compared with postoperative pathologic TNM stage. Results Compared with postoperative pathological T staging, the sensitivity of preoperative CT-T staging was 100.00% (32/ 32), the accuracy was 87.50% (28/32), the consistency with postoperative T staging was statistically significant (Kappa= 0.765); the sensitivity of preoperative CT-N staging was 93.75% (15/16), the accuracy was 93.75% (30/32)，the consistency with postoperative pathological N staging was statistically significant (Kappa=0.900); the sensitivity of preoperative CT-M staging was 100.00% (5/5), the accuracy rate was 100.00% (32/32), the consistency with postoperative pathological M staging was statistically significant (Kappa=1.000). Conclusion Revolution CT plain scan, enhanced examination and post-processing technique have important clinical value in depicting tumor location, size and morphology, delineating tumor extension, revealing lymph nodes and metastases, and preoperative TNM staging can be accurately carried out, which has guiding significance for the formulation of surgical procedures..
KEYWORDS: rectal cancer; multi-slice spiral CT; diagnosis value

参考文献：
[1] P DZIWIATR M,MA CZAK P,MIZERA M,et al.There is no difference in outcome between laparoscopic and open surgery for rectal cancer: a systematic review and Meta-analysis on short-term and long-term
oncologic outcomes[J].Tech Coloproctol,2017,21(7):1662-1664.
[2] 马立恒,孙灿辉,王春泉.多层螺旋CT 和MRI 对直肠癌术前TN 分 期的比较研究[J].影像诊断与介入放射学,2014,23(3):205-210.
[3] YITTA S,HECHT E M,SLYWOTZKY CM,et al.Added value of multiplanar reformation in the multidetector CT evaluation of the female pelvis: a pictorial review[J].Radiographics,2009,29(7):1987-2003.
[4] 陆通,杨虹,李婷,等.多层螺旋CT 在直肠癌术前T 分期诊断中的 价值[J].宁夏医学杂志,2017,39(1):45-47.
[5] 刘媛,周纯武,张红梅,等.64 排螺旋CT 结肠成像评价结直肠癌术 前TN 分期[J].中国医学影像技术,2009,25(12):2147-2149.
[6] 汪晓东,吴俊华,宋欢,等.64 排螺旋CT 在直肠癌术前分期的诊断 价值[J].现代肿瘤医学,2009,17(7):1284-1287.
[7] 梁玉安.多层螺旋CT 在结直肠癌术前TNM 分期诊断中的应用[J]. 广西医科大学学报,2017,34(2):279-283.
[8] FILIPPONE A,AMBROSINI R,FUSCHI M,et al.Preoperative T and N staging of colorectal cancer: accuracy of contrast-enhanced multi-detector row CT colonography-initial experience[J].Radiology,2004,231(1): 83-90.
[9] 丁小辉,张邦苏.多层螺旋CT 诊断直肠癌的临床价值分析[J].医学 影像学杂志,2012,22(12):2134-2135.