目的报告结肠的螺旋CT扫描方法，评估低张水灌肠螺旋CT扫描(WESCT)对大肠肿瘤性病变的诊断rn价值和限度。方法对65例已知或高度怀疑结肠病变的病人，行螺旋CT扫描。扫描前清结肠道，扫描时应用肌肉rn松弛剂和温生理盐水保留灌肠。结果 65例病人中有63例清晰显示病变，其中结肠癌48例，淋巴瘤5例，转移瘤3rn例，脓肿2例，炎性狭窄1例，盲肠类癌2例，结肠息肉2例。1例结肠息肉和1例息肉恶变WESCT未检出。48例大rn肠癌WESCT正确分期39例，其中浆膜层浸润的准确率为100％(28/28)，对异常淋巴结检出的敏感度达95.3％(rn41/43)，淋巴结转移的特异性诊断正确率为83.9％(26/31)。3例转移瘤因清晰显示病变位于肠壁并向外生长及明rn确的病史而确诊。结论低张水灌肠螺旋CT扫描对大肠癌的分期非常有价值。%Purpose Report the method of CT scan in colorectum and to determine the value and limits of water enernma spiral CT (WESCT) in diagnosing of colorectal tumors. Methods Sixty-five patients with known or doubted lesion rnin colon or rectum were examined by SCT. The diagnosis between benign and malignant was made according to the rnfindings of SCT, and all cases of colorectal carcinoma were staged according to mordified Dukes classification. Results rn 63 cases of all patients lesions were demonstrated clearly by WESCT and the sensitivity was 96.9%. Among themrn48 cases were carcinoma, and 5 cases lyphoma, 3 cases metastases, 2 cases abscess, 1 case stricture with grannulation,rn2 cases carcinoid, 2 cases polyps. 1 case polypoid and 1 case malignant polypoid adenoma(all less than 5mm) were not rndemonstrated. 42 cases of carcinoma were correctly staged in Dukes. Sensitivity and specificity for the assessment of rnlocal serosal invasion were 100% (28/28) and for lymph node involvement were 95.3% (41/43) and 83.9% (26/31)rnrespectively. 3 cases metastases were diagnosed correctly. Conclusion WESCT scan is a better method of depicting the rncolorectal tumor and allows for accurate depiction and staging of colorectal carcinoma.
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