双能量CT能谱图像对结直肠癌的诊断及术前分期中的运用价值
|
摘要
目的 :双能量CT能谱图像对结直肠癌的诊断及术前分期中的运用价值。方法 :选取2015年4月～2017年1月我院收治的经手术证实为结直肠癌患者46例,年龄48～81岁,平均年龄(58.91±10.32)岁,作为研究对象。对比术后观察双能量CT T分期诊断的影像学表现、双能量CT T分期诊断情况、双能量CT N分期诊断情况、双能量CT M分期诊断情况。结果 :在双能量CT对T分期的诊断中中,T1准确率为100%,T2准确率为75%,T3准确率为60%,T4准确率为91.3%,T期诊断总准确率为81.1%;在双能量CT对N分期的诊断中中,N0准确率为83.3%,N1准确率为92.3%,N2准确率为50%,N3准确率为50%,N期诊断总准确率为81.1%;在双能量CT对M分期的诊断中中,DukeA准确率为70%,DukeB准确率为66.7%,DukeC准确率为80%,DukeD准确率为100%,M分期诊断总准确率为81.1%。结论 :综上所述,双能量CT能谱图像在结直肠癌的诊断中能够多维度的观察患者的病况,并且对于患者来说是一种更易于接受的无创伤检查方式,相比于传统CT具有更高的术前分期准确性,从而给予外科医生更多的影像信息。
Objective The diagnosis of colorectal cancer and its application value in preoperative staging were reviT3 accuracy rate was 60%, T4 accuracy was 91.3%, and the total accuracy of t-stage diagnosis was 81.1%. ewed. Methods From April 2015 to January 2017, 46 patients with colorectal cancer were admitted to our hospital. Age 48 to 81, Mean age(58.91 ±10.32). As a research object. The imaging findings of double energy CT T staging were compared after surgery. Double energy CT T staging diagnosis. Double energy CT N staging diagnosis, Dual energy CT M staging diagnosis. Results In the diagnosis of T staging by dual-energy CT, The accuracy rate of T1 is 100%. T2 accuracy is 75%, T3 accuracy rate was 60%, T4 accuracy was 91.3%, and the total accuracy of t-stage diagnosis was 81.1%. In the diagnosis of N staging by dual-energy CT, the accuracy rate of N0 was 83.3%, N1 accuracy was 92.3%, N2 accuracy was 50%, N3 accuracy was 50%, and the total accuracy of N stage diagnosis was 81.1%. In the diagnosis of M stage by dual-energy CT, the accuracy rate of DukeA was 70%, the accuracy of DukeB was 66.7%, the accuracy of DukeC was 80%, DukeD accuracy was 100%, and the total accuracy of M stage diagnosis was 81.1%. Conclusion To sum up, In the diagnosis of colorectal cancer, dual-energy CT images can observe the patient's condition in a multidimensional way. And for patients, it's a more acceptable way to go without trauma, Compared with traditional CT, it has higher preoperative accuracy. To give the surgeon more information about the image.
Objective The diagnosis of colorectal cancer and its application value in preoperative staging were reviT3 accuracy rate was 60%, T4 accuracy was 91.3%, and the total accuracy of t-stage diagnosis was 81.1%. ewed. Methods From April 2015 to January 2017, 46 patients with colorectal cancer were admitted to our hospital. Age 48 to 81, Mean age(58.91 ±10.32). As a research object. The imaging findings of double energy CT T staging were compared after surgery. Double energy CT T staging diagnosis. Double energy CT N staging diagnosis, Dual energy CT M staging diagnosis. Results In the diagnosis of T staging by dual-energy CT, The accuracy rate of T1 is 100%. T2 accuracy is 75%, T3 accuracy rate was 60%, T4 accuracy was 91.3%, and the total accuracy of t-stage diagnosis was 81.1%. In the diagnosis of N staging by dual-energy CT, the accuracy rate of N0 was 83.3%, N1 accuracy was 92.3%, N2 accuracy was 50%, N3 accuracy was 50%, and the total accuracy of N stage diagnosis was 81.1%. In the diagnosis of M stage by dual-energy CT, the accuracy rate of DukeA was 70%, the accuracy of DukeB was 66.7%, the accuracy of DukeC was 80%, DukeD accuracy was 100%, and the total accuracy of M stage diagnosis was 81.1%. Conclusion To sum up, In the diagnosis of colorectal cancer, dual-energy CT images can observe the patient's condition in a multidimensional way. And for patients, it's a more acceptable way to go without trauma, Compared with traditional CT, it has higher preoperative accuracy. To give the surgeon more information about the image.
引文
[1]Pan P, Yu J, Wang L S. Colon Cancer:What We Eat[J]. Surgical Oncology Clinics of North America, 2018, 27(2):243.
[2]赵智强.周仲瑛教授对消化道恶性肿瘤的辨治研究[J].南京中医药大学学报, 2016, 32(1):1-3.
[3]蒋绚,王玥,王辉,等.结直肠癌的临床症状谱分析及其对肿瘤诊断时间的影响[J].中华医学杂志, 2013, 93(4):275-279.
[4]王颢,傅传刚.直肠癌术前准确分期价值及对治疗策略选择的影响[J].中国实用外科杂志, 2014, 34(1):37-40.
[5]刘荫华,姚宏伟.结直肠癌外科手术的原则与进展[J].中华消化外科杂志, 2013, 12(6):401-404.
[6]孙昊,薛华丹,刘炜,等.单次团注对比剂双源双能量CT泌尿系成像在上泌尿系显影及无痛性血尿诊断中的应用价值[J].中国医学科学院学报, 2014, 36(3):283-290.
[7]Marrelli D, Morgagni P, De G M, et al. Prognostic value of the 7th AJCC/UICC TNM classification of noncardia gastric cancer:analysis of a large series from specialized Western centers[J]. Annals of Surgery,2012, 255(3):486..
[8]郑莹,吴春晓.中国75岁以上老年人胃肠道恶性肿瘤流行状况和发展趋势[J].中华胃肠外科杂志, 2016, 19(5):481-485.
[9]吴东,周炜洵,杨红,等.放大色素内镜联合窄带成像对炎症性肠病相关异型增生和结直肠癌的诊断价值[J].中华消化内镜杂志,2017, 34(3):163-168.
[10]马小梅,黄刚,和建伟,等. DCE-MRI对直肠癌淋巴结转移评价的病理对照分析[J].临床放射学杂志, 2018, 35(1):94-99.
[11]常伟东,王东昕,于苗,等.应用腹腔化疗联合静脉化疗治疗浆膜受侵的结直肠癌的疗效观察[J].中国地方病防治杂志, 2016, 26(8):928-929.
[12]欧鸿儒,贾红明,张冠业,等.结肠癌侵犯浆膜面的多层螺旋CT表现与淋巴结转移的关系[J].广东医学院学报, 2017, 35(4):441-444.
[13]王均庆,陆风旗,张雷,等.结肠癌肠梗阻的CT检查影像学特征[J].中华消化外科杂志, 2015, 14(6):507-510.
[14]陈吉虎,武志峰,鄂林宁,等.双源CT双能量成像判断结肠癌浆膜受侵的价值[J].中国临床医学影像杂志, 2016, 27(10):725-728.
[15]王军,谭诗云,李明,等.结肠癌与大肠腺瘤及癌旁正常肠黏膜组织差异表达蛋白的筛选[J].中华肿瘤防治杂志, 2013, 20(9):646-649.
[16]陈冬梅,刘淑丹,马会明,等.肿瘤环境下脂肪间充质干细胞旁分泌因子促进结肠癌细胞侵袭[J].安徽医科大学学报, 2016, 51(1):36-41.
[17]李强,王玉涛,俞明明,等.双源CT双能量单期增强扫描检查对食管癌患者辐射剂量影响的前瞻性研究[J].中华消化外科杂志,2017, 16(5):527-532.
[18]杨雪君,赵卫,郑凌琳,等.双能量CT对结直肠癌区域淋巴结性质判定的临床研究[J].放射学实践, 2016, 31(10):957-960.
[19]周维富,邓旭锋,方智民,等.结肠癌术后11年肺转移1例报道[J].重庆医学, 2018, 46(4):575-576.
[2]赵智强.周仲瑛教授对消化道恶性肿瘤的辨治研究[J].南京中医药大学学报, 2016, 32(1):1-3.
[3]蒋绚,王玥,王辉,等.结直肠癌的临床症状谱分析及其对肿瘤诊断时间的影响[J].中华医学杂志, 2013, 93(4):275-279.
[4]王颢,傅传刚.直肠癌术前准确分期价值及对治疗策略选择的影响[J].中国实用外科杂志, 2014, 34(1):37-40.
[5]刘荫华,姚宏伟.结直肠癌外科手术的原则与进展[J].中华消化外科杂志, 2013, 12(6):401-404.
[6]孙昊,薛华丹,刘炜,等.单次团注对比剂双源双能量CT泌尿系成像在上泌尿系显影及无痛性血尿诊断中的应用价值[J].中国医学科学院学报, 2014, 36(3):283-290.
[7]Marrelli D, Morgagni P, De G M, et al. Prognostic value of the 7th AJCC/UICC TNM classification of noncardia gastric cancer:analysis of a large series from specialized Western centers[J]. Annals of Surgery,2012, 255(3):486..
[8]郑莹,吴春晓.中国75岁以上老年人胃肠道恶性肿瘤流行状况和发展趋势[J].中华胃肠外科杂志, 2016, 19(5):481-485.
[9]吴东,周炜洵,杨红,等.放大色素内镜联合窄带成像对炎症性肠病相关异型增生和结直肠癌的诊断价值[J].中华消化内镜杂志,2017, 34(3):163-168.
[10]马小梅,黄刚,和建伟,等. DCE-MRI对直肠癌淋巴结转移评价的病理对照分析[J].临床放射学杂志, 2018, 35(1):94-99.
[11]常伟东,王东昕,于苗,等.应用腹腔化疗联合静脉化疗治疗浆膜受侵的结直肠癌的疗效观察[J].中国地方病防治杂志, 2016, 26(8):928-929.
[12]欧鸿儒,贾红明,张冠业,等.结肠癌侵犯浆膜面的多层螺旋CT表现与淋巴结转移的关系[J].广东医学院学报, 2017, 35(4):441-444.
[13]王均庆,陆风旗,张雷,等.结肠癌肠梗阻的CT检查影像学特征[J].中华消化外科杂志, 2015, 14(6):507-510.
[14]陈吉虎,武志峰,鄂林宁,等.双源CT双能量成像判断结肠癌浆膜受侵的价值[J].中国临床医学影像杂志, 2016, 27(10):725-728.
[15]王军,谭诗云,李明,等.结肠癌与大肠腺瘤及癌旁正常肠黏膜组织差异表达蛋白的筛选[J].中华肿瘤防治杂志, 2013, 20(9):646-649.
[16]陈冬梅,刘淑丹,马会明,等.肿瘤环境下脂肪间充质干细胞旁分泌因子促进结肠癌细胞侵袭[J].安徽医科大学学报, 2016, 51(1):36-41.
[17]李强,王玉涛,俞明明,等.双源CT双能量单期增强扫描检查对食管癌患者辐射剂量影响的前瞻性研究[J].中华消化外科杂志,2017, 16(5):527-532.
[18]杨雪君,赵卫,郑凌琳,等.双能量CT对结直肠癌区域淋巴结性质判定的临床研究[J].放射学实践, 2016, 31(10):957-960.
[19]周维富,邓旭锋,方智民,等.结肠癌术后11年肺转移1例报道[J].重庆医学, 2018, 46(4):575-576.