Xiong Lin, Chintapalli Kedar N, Dodd Gerald D, Chopra Shailendra, Pastrano Joe A, Hill Cheryl, Leyendecker John R, Abbott Robert M, Grayson David, Feig John
Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229-3900, USA.
AJR Am J Roentgenol. 2004 Apr;182(4):905-9. doi: 10.2214/ajr.182.4.1820905.
This study was performed to determine the frequency and patterns of colon wall thickening seen on CT of patients with adenocarcinoma of the colon.
Preoperative abdominal and pelvic CT scans of 185 patients with surgically proven adenocarcinoma of the colon were retrospectively evaluated by three abdominal radiologists for the presence of colon obstruction and colon wall thickening proximal to the colon adenocarcinoma. The distributions and patterns of colon wall thickening were categorized by consensus. CT findings were compared with pathologic findings. Fisher's exact test was used to determine the statistical significance of any associations.
Of 185 patients, CT findings of 20 (10.8%) showed colon wall thickening. Of these, the adenocarcinoma obstructed the colon in 19 patients (p < 0.01). Colon obstruction was partial in 10 patients (53%) and complete in nine (47%). Colon wall thickening was contiguous to the tumor in 14 (70%) patients and noncontiguous in six (30%). Segmental and pancolonic, patchy and diffuse, and dependent and nondependent colon wall thickening was observed in 10 patients (50%) in each category. Associated small-bowel wall thickening was shown in 10 (50%) of the 20 patients. Pathologic examination showed colon wall thickening to be due to edema in all cases.
Colon wall edema can occur proximal to colon adenocarcinoma, is almost always associated with colon obstruction, and is predominantly contiguous with the obstructing adenocarcinoma.
本研究旨在确定结肠癌患者CT检查中结肠壁增厚的频率及模式。
对185例经手术证实为结肠癌的患者术前腹部和盆腔CT扫描进行回顾性分析，由三位腹部放射科医生评估是否存在结肠梗阻以及结肠癌近端的结肠壁增厚情况。通过共识对结肠壁增厚的分布和模式进行分类。将CT检查结果与病理检查结果进行比较。采用Fisher精确检验确定任何关联的统计学意义。
185例患者中，20例（10.8%）的CT检查结果显示结肠壁增厚。其中，19例患者（p < 0.01）的腺癌导致结肠梗阻。10例患者（53%）为部分性结肠梗阻，9例（47%）为完全性结肠梗阻。14例（70%）患者的结肠壁增厚与肿瘤相邻，6例（30%）不相邻。在每类中各有10例患者（50%）观察到节段性和全结肠性、斑片状和弥漫性、依赖性和非依赖性结肠壁增厚。20例患者中有10例（50%）显示伴有小肠壁增厚。病理检查显示所有病例中结肠壁增厚均由水肿引起。
结肠腺癌近端可出现结肠壁水肿，几乎总是与结肠梗阻相关，且主要与梗阻性腺癌相邻。
