Department of Internal and Public Medicine, Section of Radiology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124, Bari, Italy.
Radiol Med. 2012 Mar;117(2):254-67. doi: 10.1007/s11547-011-0782-6. Epub 2012 Jan 21.
The authors sought to evaluate the diagnostic accuracy of multidetector-row computed tomography (MDCT) performed with two different hypodense endoluminal contrast agents for the preoperative staging of colosigmoideal cancer.
Seventy consecutive patients with an endoscopically and histologically proven diagnosis of colosigmoideal cancer underwent MDCT examination. Thirty-five patients were evaluated with water MDCT colonography and the remaining 35 with air MDCT colonography. Patients were randomly assigned to the air or water groups for staging. Transverse images and multiplanar reconstructions (MPR) were retrospectively examined by two blinded expert radiologists in order to assess T and N parameters, and the results were compared with histological findings.
The overall diagnostic accuracy of MDCT was 68.6% for water and 62.8% for air colonography. In the evaluation of the T parameter, the accuracy values were 88.6% for water and 80% for air colonography. In staging of the N parameter, the accuracy values were 77.1% and 74.3% for water and air MDCT colonography, respectively.
MDCT examination can be proposed for the local staging of colosigmoideal cancer. Water is more accurate than air in evaluation of the T parameter, whereas the kind of endoluminal contrast material does not influence the definition of the N parameter.
作者旨在评估两种不同低浓度腔内对比剂在术前结直肠侧向肿瘤分期中的多排螺旋 CT(MDCT)诊断准确性。
70 例经内镜和组织学证实的结直肠侧向肿瘤患者接受了 MDCT 检查。其中 35 例患者接受水 MDCT 结肠成像检查,其余 35 例患者接受空气 MDCT 结肠成像检查。患者随机分为空气或水组进行分期。两位盲法专家放射科医生回顾性地对横断面图像和多平面重建(MPR)进行评估,以评估 T 和 N 参数,并将结果与组织学发现进行比较。
水 MDCT 结肠成像的整体诊断准确性为 68.6%,空气 MDCT 结肠成像的为 62.8%。在 T 参数评估中,水 MDCT 结肠成像的准确率为 88.6%,空气 MDCT 结肠成像的为 80%。在 N 参数分期中,水 MDCT 结肠成像和空气 MDCT 结肠成像的准确率分别为 77.1%和 74.3%。
MDCT 检查可用于结直肠侧向肿瘤的局部分期。在 T 参数评估中,水比空气更准确,而腔内对比剂的种类不影响 N 参数的定义。