结肠癌CT仿真内镜与电子结肠镜的对照研究(附30例报告)

摘要

Abstract:Objective To evaluate the clinical application of CT virtual endoscopy (CTVE) in the diagnosis and treatment of colonic carcinoma. Methods We collected 30 patients pathologically proven to have colonic carcinomas as examined by CTVE and electronic colonoscopy (EC), correlating the CTVE and EC images respectively with surgical pathology in three aspects: tumor morphological features, degree of circumferential bowel wall involvement and longitudinal extent of tumor. Results CTVE imaging of colonic carcinomas showed morphological features: polypoid pattern (11 patients), ulcerative pattern (11), and infiltrative pattern (8); degree of circumferential bowel wall involvement: less than 1/2 (4 patients), from 1/2 to 3/4 (6), and more than 3/4 (20); and their longitudinal extent: 1.0-3.0?cm (7 patients), 31-5.0?cm (10), and 5.1-11.0?cm (13). Correlation of CTVE and EC with surgical pathology was found. Comparison of CTVE with surgical pathology showed tumor morphological features: concordant (26 patients), and disconcordant (4); degree of circumferential bowel wall involvement: concordant (25), disconcordant (5); and longitudinal extent of the tumor: concordant (23), disconcordant (7). Comparison of EC with surgical pathology showed tumor morphological features: concordant (22 patients), disconcordant (8); degree of circumferential bowel wall involvement: concordant (28), disconcordant (2); and longitudinal extent of the tumor: concordant (14), disconcordant (3), and undefined by EC (13). Conclusions The images obtained by CTVE in colonic carcinoma are similar to those obtained by EC. CTVE is an excellent alternative to EC for patients who cannot tolerate EC and for cases with incomplete EC.%目的探讨CT仿真内镜在结肠癌诊治中的临床应用.方法收集30例结肠癌的CT仿真内镜、电子结肠镜及手术病理的材料,并从肿块分型、病变环周侵犯范围及病变长度等三方面进行比较.结果结肠癌的CT仿真内镜征象分析:(1) 肿块分型:肿块型11例、溃疡型11例、浸润型8例.(2)环周侵犯范围:侵犯肠腔≤1/2共4例、侵犯肠腔1/4-3/4共6例、侵犯肠腔≥3/4共20例.(3) 病变长度:1.0-3.0?cm共7例,3.1-5.0?cm共10例,5.1-1.0?cm共13例.CT仿真内镜、电子结肠镜与手术病理结果对照:(1) CT仿真内镜与手术病理结果比较:肿块分型相同26例,不同4例;环周侵犯范围相同25例,不同5例;病变长度相同23例,不同7例.(2) 电子结肠镜与手术病理结果比较:肿块分型相同22例,不同8例;环周侵犯范围相同28例,不同2例;病变长度相同14例,不同3例,电子结肠镜不能确定病变长度13例.结论 CT仿真内镜能获得类似电子结肠镜所见的图像,可以作为不能进行电子结肠镜检查,或电子结肠镜检查观察不全面的结肠癌患者的一种良好补充检查手段.