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腹腔镜手术前使用多排螺旋计算机断层扫描对结直肠癌的局部侵犯、转移性淋巴结及肠系膜血管变异进行术前评估。

Preoperative evaluation of local invasion and metastatic lymph nodes of colorectal cancer and mesenteric vascular variations using multidetector-row computed tomography before laparoscopic surgery.

作者信息

Kanamoto Takaaki, Matsuki Mitsuru, Okuda Junji, Inada Yuki, Tatsugami Fuminari, Tanikake Masato, Yoshikawa Shushi, Narabayashi Isamu, Kawasaki Hiroshi, Tanaka Keitaro, Yamamoto Tetsuhisa, Tanigawa Nobuhiko, Egashira Yutaro, Shibayama Yuro

机构信息

Department of Radiology, Osaka Medical College, Osaka, Japan.

出版信息

J Comput Assist Tomogr. 2007 Nov-Dec;31(6):831-9. doi: 10.1097/RCT.0b013e3180517af3.

Abstract

OBJECTIVE

To evaluate local invasion and lymph nodes metastasis of colorectal cancer and mesenteric vascular variations using multidetector-row computed tomography (MDCT) before laparoscopic colorectal surgery.

METHODS

Fifty-one patients with colorectal cancer underwent MDCT. The evaluation items were as follows: (1) local invasion; (2) detected lymph nodes evaluated by short-axis diameter, long-axis diameter, short/long axis diameter ratio, and computed tomography (CT) attenuation; and (3) visualization of mesenteric artery and vein by 3-dimensional-CT angiography.

RESULTS

First, in the evaluation of local invasion, overall accuracy was 94.1%. Second, the point of 0.8 or greater in short/long-axis diameter ratio was best index for the diagnosis of metastatic lymph nodes. Using this index, the accuracy of the diagnosis per node was 80.5%. Third, 3-dimensional-CT angiography correctly demonstrated variations of the mesenteric artery and vein.

CONCLUSIONS

The MDCT was effective for evaluation of local invasion and lymph nodes metastasis of colorectal cancer and mesenteric vascular variations before laparoscopic surgery.

摘要

目的

在腹腔镜结直肠癌手术前,使用多排螺旋计算机断层扫描(MDCT)评估结直肠癌的局部侵犯、淋巴结转移及肠系膜血管变异情况。

方法

51例结直肠癌患者接受了MDCT检查。评估项目如下:(1)局部侵犯;(2)通过短轴直径、长轴直径、短/长轴直径比及计算机断层扫描(CT)衰减评估检测到的淋巴结;(3)通过三维CT血管造影观察肠系膜动静脉。

结果

第一,在局部侵犯评估中,总体准确率为94.1%。第二,短/长轴直径比≥0.8是诊断转移性淋巴结的最佳指标。采用该指标,每个淋巴结的诊断准确率为80.5%。第三,三维CT血管造影正确显示了肠系膜动静脉的变异情况。

结论

MDCT对于在腹腔镜手术前评估结直肠癌的局部侵犯、淋巴结转移及肠系膜血管变异是有效的。

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