四川医学
四川醫學
사천의학
Sichuan Medical Journal
2015年
11期
1591-1594
,共4页
低位直肠癌%小淋巴结转移%术前评估%多层螺旋 CT
低位直腸癌%小淋巴結轉移%術前評估%多層螺鏇 CT
저위직장암%소림파결전이%술전평고%다층라선 CT
rectal carcinoma%lymph node metastasis%preoperative assessment%MSCT
目的：初步探讨低位直肠癌直肠周围脂肪间隙的平均 CT 值对于判断低位直肠癌周围脂肪间隙侵犯和直肠周围小淋巴结转移的应用价值。方法前瞻性纳入2011年7月至2013年2月于本院拟行外科手术治疗并被术前病理结果证实为低位直肠癌患者。所有患者均于术前接受 Philips Brilliance 64排螺旋 CT 全腹检查,并于后处理工作站对图像进行观察测量。采用 ROI CT 值测量法分别测出每个病例在平扫及增强时直肠周围脂肪间隙的平均 CT 值。结合病理结果,根据有无直肠周围脂肪间隙侵犯将病例分为 T(+)、T(-)两组,根据有无直肠周围小淋巴结转移将病例分为 N (+)、N(-)两组,分别比较 T(+)、T(-)两组患者及 N(+)、N(-)两组患者的 ROI 平均 CT 值的差异性。结果 T(-)组与T(+)组患者直肠周围脂肪间隙 ROI CT 值差异有统计学意义(P <0．05),N(-)组与 N(+)组患者直肠周围脂肪间隙 ROI CT 值差异有统计学意义(P <0．05)。其 ROC 诊断效能曲线下面积有统计学意义(平扫：A Z =0．686,P =0．016；增强：A Z =0．682,P =0．019)。平扫及增强时,当 ROI 平均 CT 值取-80~-70 Hu 为诊断直肠周围间隙侵犯参考值；平扫及增强时,当 ROI 平均 CT 值取-70~-60Hu,为诊断直肠周围小淋巴结转移的参考值。结论直肠周围脂肪间隙 CT 表现分型及 ROI 平均 CT 值的测量能够为直肠癌周围脂肪间隙侵犯和直肠周围小淋巴结转移提供辅助诊断依据。
目的：初步探討低位直腸癌直腸週圍脂肪間隙的平均 CT 值對于判斷低位直腸癌週圍脂肪間隙侵犯和直腸週圍小淋巴結轉移的應用價值。方法前瞻性納入2011年7月至2013年2月于本院擬行外科手術治療併被術前病理結果證實為低位直腸癌患者。所有患者均于術前接受 Philips Brilliance 64排螺鏇 CT 全腹檢查,併于後處理工作站對圖像進行觀察測量。採用 ROI CT 值測量法分彆測齣每箇病例在平掃及增彊時直腸週圍脂肪間隙的平均 CT 值。結閤病理結果,根據有無直腸週圍脂肪間隙侵犯將病例分為 T(+)、T(-)兩組,根據有無直腸週圍小淋巴結轉移將病例分為 N (+)、N(-)兩組,分彆比較 T(+)、T(-)兩組患者及 N(+)、N(-)兩組患者的 ROI 平均 CT 值的差異性。結果 T(-)組與T(+)組患者直腸週圍脂肪間隙 ROI CT 值差異有統計學意義(P <0．05),N(-)組與 N(+)組患者直腸週圍脂肪間隙 ROI CT 值差異有統計學意義(P <0．05)。其 ROC 診斷效能麯線下麵積有統計學意義(平掃：A Z =0．686,P =0．016；增彊：A Z =0．682,P =0．019)。平掃及增彊時,噹 ROI 平均 CT 值取-80~-70 Hu 為診斷直腸週圍間隙侵犯參攷值；平掃及增彊時,噹 ROI 平均 CT 值取-70~-60Hu,為診斷直腸週圍小淋巴結轉移的參攷值。結論直腸週圍脂肪間隙 CT 錶現分型及 ROI 平均 CT 值的測量能夠為直腸癌週圍脂肪間隙侵犯和直腸週圍小淋巴結轉移提供輔助診斷依據。
목적：초보탐토저위직장암직장주위지방간극적평균 CT 치대우판단저위직장암주위지방간극침범화직장주위소림파결전이적응용개치。방법전첨성납입2011년7월지2013년2월우본원의행외과수술치료병피술전병리결과증실위저위직장암환자。소유환자균우술전접수 Philips Brilliance 64배라선 CT 전복검사,병우후처리공작참대도상진행관찰측량。채용 ROI CT 치측량법분별측출매개병례재평소급증강시직장주위지방간극적평균 CT 치。결합병리결과,근거유무직장주위지방간극침범장병례분위 T(+)、T(-)량조,근거유무직장주위소림파결전이장병례분위 N (+)、N(-)량조,분별비교 T(+)、T(-)량조환자급 N(+)、N(-)량조환자적 ROI 평균 CT 치적차이성。결과 T(-)조여T(+)조환자직장주위지방간극 ROI CT 치차이유통계학의의(P <0．05),N(-)조여 N(+)조환자직장주위지방간극 ROI CT 치차이유통계학의의(P <0．05)。기 ROC 진단효능곡선하면적유통계학의의(평소：A Z =0．686,P =0．016；증강：A Z =0．682,P =0．019)。평소급증강시,당 ROI 평균 CT 치취-80~-70 Hu 위진단직장주위간극침범삼고치；평소급증강시,당 ROI 평균 CT 치취-70~-60Hu,위진단직장주위소림파결전이적삼고치。결론직장주위지방간극 CT 표현분형급 ROI 평균 CT 치적측량능구위직장암주위지방간극침범화직장주위소림파결전이제공보조진단의거。
Objective To evaluate the clinical value of ROI mean CT attenuation value in judgement of pararectal space invasion and small lymph nodes metastases on lower rectal cancer. Methods Prospectively enrolled 69 cases diagnosed as lower rectal cancer from July 2011 to Feb 2013. All the cases were assessed by MSCT before operation,,and the images were observed and measured in post processing work station . ROI CT value measurement method was used respectively to measure average CT value of each case in the scan and enhanced of fat gap around the rectum. Combined with the pathological results, according to the presence or absent of fat gap around the rectum infringement were can be divided into T( + ), T(-)two groups, according to the presence or absent of rectum around small lymph node metastasis were divided into two groups N( + ), N(-). then, between two groups of patients, T( + ), T(-)compared the ROI of the average CT value with N( + ), N(-). Results The differences of ROI mean CT value of pararectal space between T( + )and T(-), N( + )and N(-)patients were statistically significant(P < 0. 05);furthermore,the accuracy of diagnosing pararectal space invasion and small lymph nodes metastases by ROI mean CT attenuation value were statistically significant(P < 0. 05). The best cut-off ROI mean CT attenuation value for pararectal space invasion and small lymph nodes metastases were -80 Hu-70Hu and -70 Hu-60 Hu,respectively. Conclusion Fat gap garound the rectum and type of CT performance and the average ROI CT value could be supply diagnostic evidence for pararectal space invasion and small lymph nodes metastases.
