CAJ | 학술논문

目的:分析直肠周围间隙淋巴结转移的多层CT(MSCT)表现,探讨CT诊断直肠癌淋巴结转移(N分期)的价值.方法:术前行盆腔MSCT检查的154例直肠癌病例,均行全直肠系膜切除术,对直肠周围间隙淋巴结进行病理检查,采用双盲法,记录每枚淋巴结的CT表现,包括淋巴结短轴直径、边缘、密度、分布方式.结果:以手术病理为标准.直肠周围间隙淋巴结CT检出率为86.3%(471/546),病理共检出直肠周围间隙淋巴结546枚,CT检出481枚,其中471枚(阳性172枚,阴性299枚)淋巴结与病理相匹配.CT诊断直肠周围间隙淋巴结转移的各种判断标准(淋巴结大小、边缘、密度、分布方式)的敏感性分别为83.1%、72.2%、70.1%、73.5%,特异性分别为80.5%、85.1%、82.4%、75.1%.CT显示的淋巴结大小、边缘、密度、分布方式的差异与阳性率有显著相关性,P<0.005.结论:直肠周围间隙淋巴结有良性和恶性淋巴结,综合分析淋巴结大小、形态、密度及分布对诊断直肠周围间隙淋巴结转移有很大帮助.
목적:분석직장주위간극림파결전이적다층CT(MSCT)표현,탐토CT진단직장암림파결전이(N분기)적개치.방법:술전행분강MSCT검사적154례직장암병례,균행전직장계막절제술,대직장주위간극림파결진행병리검사,채용쌍맹법,기록매매림파결적CT표현,포괄림파결단축직경、변연、밀도、분포방식.결과:이수술병리위표준.직장주위간극림파결CT검출솔위86.3%(471/546),병리공검출직장주위간극림파결546매,CT검출481매,기중471매(양성172매,음성299매)림파결여병리상필배.CT진단직장주위간극림파결전이적각충판단표준(림파결대소、변연、밀도、분포방식)적민감성분별위83.1%、72.2%、70.1%、73.5%,특이성분별위80.5%、85.1%、82.4%、75.1%.CT현시적림파결대소、변연、밀도、분포방식적차이여양성솔유현저상관성,P<0.005.결론:직장주위간극림파결유량성화악성림파결,종합분석림파결대소、형태、밀도급분포대진단직장주위간극림파결전이유흔대방조.
Purpose: To analyze the appearances of mesorectun in MSCT images, and to investigate the role of MSCT in diagnosis of lymph node metastases(N staging) in rectal carcinoma.Methods: One hundred and fifty - four patients who had undergone total mesorectal excision(TME) for rectal carcinoma were enrolled in this study after preoperative CT examination. The positive - nodes were considered on the basis of pathological examination. The characteristics of each detectable node(LN) were recorded by two radiologists, blinded for the histological results for the following aspects: Short - axis diameter, mar-gin, density, location and distribution of LN within the mesorectum. Results: Of all, 86.396 (471/546) mesorectal lymph nodes were showed by CT, 471 nodes (299 benign, 172 malignant)could be matched ex-actly with nodes found on pathologic findings. The diameters, margin, density, location and distribution of LN within the mesorectum showed significant correlation with the node- positivity, P < 0.005. The sensitivity of each diagnostic criterion was: 83.1% .for diameter, 72.2% for margin, 70.1% for density and 73.5% for distribution. The specificity was: 80.5% for diameter,85.1% for margin,82.4% for density, 75.1% for distribution. Conclusion: It was probably helpful to improve the diagnosis of mesorectal lymph node metastases by considering the size, margin, density, location and distribution of the lymph nodes.