目的:总结进展期结肠癌局部浸润的多层螺旋CT(MSCT)特征.方法:经手术病理证实的进展期结肠癌患者31例,术前行MSCT检查.以病理切片所见为标准,对术前影像资料进行回顾性对比分析.结果:对照手术病理,31例进展期结肠癌患者中,以MSCT显示肠壁增厚、伴肠周脂肪间隙内条索状或云絮状密度增高影、伴肠壁外相续楔形或结节状软组织密度影判定癌肿局部浸润至深肌层、浆膜外的准确性分别为77.42%、22.58%、80.65%,敏感性分别为37.50%、13.04%、78.26%,特异性分别为91.3%、50.00%、87.50%.MSCT显示肿块旁淋巴结肿大判定淋巴结转移的准确性为80.65%,敏感性为61.54%,特异性为94.44%.结论:进展期结肠癌的局部浸润具有一定的MSCT表现特征,MSCT征象的正确识别和对肿瘤局部浸润程度的评价有助于制定合理的治疗方案及判断预后.%Objective:To investigate the multi-slice spiral CT(MSCT) features of local infiltration in advanced colonic carcinoma. Methods:Thirty-one patients with advanced colonic carcinoma identified by histopathology were examined using the multi-slice spiral CT before operation. Compared with the histopathologic examination features, the preoperative imaging data in all cases were retrospectively analyzed. Results:Compared with the postoperative histopathological results of 31 cases with advanced colonic carcinoma,the multi-slice spiral CT imaging showed that bowel wall thickened, the intestinal fat gap had the cable or clouding high density imaging complicated with nodular and wedge-shaped shadow, which identified that the accuracy, sensitivity and specificity of local infiltration degree of tumor were 77. 42,22. 58% &80. 65%,37. 50%,13. 04% &78. 26%,and 91. 3%,50. 00% &87. 50%, respectively,and the accuracy,sensitivity and specificity of lymph node metastses were 80. 65%,61. 54% and 94. 44%,respectively. Conclusions:The MSCT imaging of local infiltration in advanced colonic carcinoma show some special MSCT features, which can identify and evaluate the local infiltration degree of tumor,help to formulate the treatment protocol and predict prognosis.
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