CT和CTA对大肠癌骨转移的诊断价值比较

摘要

Objective To investigate the diagnostic value of CT angiography (CTA) in colorectal cancer patients with bone metastasis.Methods Thirty-six patients with colorectal cancer who were diagnosed and treated in our hospital from July 2013 to January 2016 were enrolled in the study,and the patients who were diagnosed as colorectal cancer bone metastases by whole body isotope bone scanning,CT,X-ray imaging were randomly divided into two groups:research group (n =19) and control group (n =17).The patients in both groups received abdominal CT examination,moreover,the patients in research group,on this basis,were examined by volume rendering (VR) technique.Taking laboratory tests results combined with tumor acoustic imaging results as gold standard to analyze the sensitivity,specificity,accuracy and Kappa value of CT and CTA in diagnosis of bone metastasis of colorectal cancer,and to compare the total number of bone metastasis lesions of colorectal cancer and lesion size as well as minimal lesion volume showed by CT or CTA examination.Results Both CT and CTA could diagnose definitely colorectal cancer bone metastasis,moreover,there were no significant difference in sensitivity,specificity,accuracy and Kappa value in diagnosis of bone metastasis of colorectal cancer between the two examination methods (P ＞ 0.05).The total numbers of metastatic lesions in reearch group were more than those in control group,and the numbers of metastasis lesions of size 0 ～ 1 cm and 1 ～ 3cm in research group were more than those in control group,moreover,the smallest lesion volume in research group was less than that in control group (P ＜ 0.05).Conclusion Both CT and CTA in diagnosis of colorectal cancer bone metastases have better effects,moreover,both examination methods have higher sensitivity,specificity and accuracy,however,CTA is benefit to determine the number,size and location of bone metastases,moreover,which can show clearly micrometastasis lesions.%目的 探讨CT血管造影术(CTA)在大肠癌骨转移患者中的诊断价值.方法 选取诊治的大肠癌患者,并经全身同位素骨扫描、CT、X线等影像学检查确诊为大肠癌骨转移患者36例,随机分为研究组19例和对照组17例.2组患者均给予腹部CT检查,研究组患者在此基础上加用容积再现(volume rendering,VR)技术.以实验室检查结合肿瘤声学造影等结果为金标准,分析CT与CTA诊断大肠癌骨转移的敏感度、特异度、准确性及Kappa值,比较CT与CTA检查显示的大肠癌骨转移病灶的总数目、病灶大小及最小病灶体积.结果 两种检查方式均能较好的诊断大肠癌骨转移,但两种方式在诊断大肠癌骨转移的敏感度、特异度、准确性及Kappa值比较差异均无统计学意义(P＞0.05).研究组的转移病灶总数多于对照组,研究组的0～1.0 cm和1.1 ～3.0 cm的转移灶数多于对照组,且研究组发现的最小病灶体积小于对照组,差异均有统计学意义(P＜0.05).结论 CT与CTA在大肠癌骨转移的诊断方面均有着较好的效果,且此两种检查方式在诊断大肠癌骨转移方面均有着较高的敏感性、特异性、准确性,但CTA更有利于骨转移灶的数目、大小、部位的确定,可清楚的显示出微小转移灶.