Lupo L, Angelelli G, Pannarale O, Altomare D, Macarini L, Memeo V
Istituto di Clinica Chirurgica, Università di Bari, Italy.
Int J Colorectal Dis. 1996;11(2):60-4. doi: 10.1007/BF00342461.
A new technique in the preoperative staging computed tomography of rectal cancer using a water enema to promote full distension of the rectum was compared with standard CT in a non-randomised blind study. One hundred and twenty-one patients were enrolled. There were 57 in the water enema CT group and 64 in the standard group. The stage of the disease was assessed following strict criteria and tested against the pathological examination of the resected specimen. Water enema CT was significantly more accurate than standard CT with an accuracy of 84.2% vs. 62.5% (Kappa: 0.56 vs. 0.33: Kappa Weighted: 0.93 vs. 0.84). The diagnostic gain was mainly evident in the identification of rectal wall invasion within or beyond the muscle layer (94.7 vs. 61). The increased accuracy was 33.7% (CL95: 17-49; P < 0.001). The results indicate that water enema CT should replace CT for staging rectal cancer and may offer an alternative to endorectal ultrasound.
在一项非随机盲法研究中，对一种使用水灌肠促进直肠充分扩张的直肠癌术前分期计算机断层扫描新技术与标准CT进行了比较。共纳入121例患者。水灌肠CT组57例，标准组64例。按照严格标准评估疾病分期，并与切除标本的病理检查结果进行对照。水灌肠CT的准确性显著高于标准CT，准确率分别为84.2%和62.5%（卡帕值：0.56对0.33；卡帕加权值：0.93对0.84）。诊断优势主要体现在识别肌层内或肌层外的直肠壁侵犯方面（94.7对61）。准确性提高了33.7%（95%置信区间：17 - 49；P < 0.001）。结果表明，水灌肠CT应取代CT用于直肠癌分期，并且可能成为直肠内超声的一种替代方法。
