目的 探讨MSCT平扫加增强检查联合后处理技术在结肠癌术前诊断及分期中的应用价值.方法 回顾性分析2011年9月～2015年12月温州市第七人民医院诊治的90例结肠癌患者的临床资料,记录所有患者的MSCT平扫加增强检查特征,并进行联合后处理技术分析,比较术前TNM分期进行诊断与术后病理结果.结果 90例结肠癌患者中,35例患者病灶部位在升结肠和盲部、22例在乙状结肠、18例在直肠、10例在横结肠、5例在降结肠;MSCT平扫加增强检查特征主要为肠壁增厚、肠腔狭窄、肠腔内肿块、肠壁的异常强化.以病理结果为标准,MSCT对结肠癌T1～T4期的诊断准确率分别为100％、75.0％、81.8％、100％,符合率为85.6％,Kappa检验值为0.772;MSCT对结肠癌N0～N2期的诊断准确率分别为100％、78.6％、92.3％,符合率为82.2％,Kappa检验值为0.571;MSCT对结肠癌M0～M1期诊断准确率、符合率都为100.0％,一致性为1.000.结论 MSCT平扫加增强检查联合后处理技术在结肠癌的术前诊断能够较清晰呈现病灶部位特征,结肠癌TNM分期较为准确,诊断和分期结果与病理分析结果保持良好一致性,具有十分重要的应用价值.%Objective To explore the application values of MSCT plain scan and enhanced examination combined post processing technique in preoperative diagnosis and staging of colon cancer.Methods From September 2011 to December 2015,in Seventh People's Hospital of Wenzhou City,the clinical data of 90 colon cancer patients were retrospectively analyzed.All patients were recorded MSCT plain scan and enhanced scan characteristics,and they were given the post processing,compared with the preoperative diagnosis and staging by the postoperative pathological results.Results In the 90 patients,there were 35 patients were lesions located in ileocecum and ascending colon,10 patients were transverse colon,5 patients were descending colon,22 patients were sigmoid colon and 18 patients were rectum;MSCT scan and enhanced scan abnormal enhancement was mainly characterized by bowel wall thickening,stenosis,intraluminal mass and intestinal wall.As the pathological results as the standard,the diagnostic accuracy of MSCT on colon cancer T1-T4 stage were 100％,75％,81.8％,100％,the coincidence rate was 85.6％,the Kappa test value was 0.772;the diagnostic accuracy of MSCT on colon cancer N0-N2 stage were 100％,78.6％ and 92.3％,the coincidence rate is 82.2％,the Kappa test value was 0.571;MSCT on colon cancer M0-M1 diagnosis accuracy,the coincidence rate were 100％,the consistency was 1.000.Conclusion MSCT plain scan and enhanced examination combined post processing technique in preoperative diagnosis of colon cancer can effectively display the pathological characteristics of colon cancer,it can be better on colorectal cancer preoperative clinical staging TNM,it has good consistency with pathological results that has very important application values.
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