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计算机断层扫描在结直肠癌术前分期中的准确性。

The accuracy of computed tomography in the pretreatment staging of colorectal cancer.

作者信息

Tan Yi-Nuo, Li Xiao-Fen, Li Jing-Jing, Song Yong-Mao, Jiang Biao, Yang Jiao, Yuan Ying

出版信息

Hepatogastroenterology. 2014 Jul-Aug;61(133):1207-12.

Abstract

Colorectal cancer (CRC) is one of the most frequent cancers around the world. Multimodality therapies are used for CRC including surgery, chemotherapy, radiotherapy and targeted therapy. Correct treatment plan depends greatly on the accurate pretreatment staging. Computed tomography (CT) is a widely used detection and staging modality for CRC patients in clinical practice. The role of CT in assessing the patients with CRC has been well established, but the accuracy of pretreatment staging by CT varies in different reports. With the development of CT techniques, some reformations such as multi-detector CT (MDCT), CT with water enema or air insufflations, multiple planner reconstruction (MPR) help to give us higher resolution images in shorter time. The accuracy of CT for N staging was still not so ideal, but CT played an important role in chest and liver staging. Magnetic resonance imaging (MRI) and endorectal ultrasound (ERUS) may provide more precise images and evaluation of local T and N staging for rectal cancer. And positron emission tomography (PET) or PET/CT is recommended as a complement of CT, only for cases suspected of residual or recurrent colorectal carcinoma or before metastasectomy, not for routine use.

摘要

结直肠癌(CRC)是全球最常见的癌症之一。CRC的治疗采用多模式疗法,包括手术、化疗、放疗和靶向治疗。正确的治疗方案很大程度上取决于准确的术前分期。计算机断层扫描(CT)是临床实践中广泛用于CRC患者检测和分期的方法。CT在评估CRC患者中的作用已得到充分确立,但不同报告中CT术前分期的准确性有所不同。随着CT技术的发展,一些改进,如多排螺旋CT(MDCT)、水灌肠或空气注入CT、多平面重建(MPR),有助于在更短的时间内为我们提供更高分辨率的图像。CT对N分期的准确性仍不太理想,但CT在胸部和肝脏分期中发挥着重要作用。磁共振成像(MRI)和直肠内超声(ERUS)可能为直肠癌提供更精确的图像和局部T和N分期评估。正电子发射断层扫描(PET)或PET/CT仅在怀疑结直肠癌残留或复发的病例中或在转移灶切除术前作为CT的补充推荐使用,不用于常规检查。

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