Garretti L, Cassinis M C, Regge D, Drogo M, Trovato C
Istituto di Radiologia, Università degli Studi, Torino.
Minerva Chir. 1997 Jun;52(6):717-25.
We report our personal experience on endorectal US and CT in the preoperative staging of rectal carcinoma. Our series includes 64 cases (38 male and 26 female) evaluated with intrarectal sonography; 38 of these patients underwent also CT-study of the lower abdomen. Using both imaging techniques infiltration of the rectal wall and adjacent structures and lymph node involvement were studied. The results of our study refer to 58 patients who underwent endorectal US, 31 of whom studied also with CT. Referring to the T-parameter with ultrasound 41 correct diagnosis were obtained, in 13 cases the lesion was over-staged and in 4 cases understaged. The sensitivity, specificity and diagnostic accuracy was respectively 89.5%, 60% and 79.3%. With CT 23 diagnosis were correct, in 1 case the lesion was overstaged and in 7 cases understaged; sensitivity, specificity and diagnostic accuracy concerning rectal wall infiltration were respectively 72%, 83.3% and 74.2%. The evaluation of the N-parameter demonstrated low value of sensitivity with both US (15.8%) and CT (42.9%). Considering the results of our series, we feel that it is necessary to use both imaging techniques because results obtained are complementary referring to the T-parameter, although N-parameter were a little significant.
我们报告了关于直肠内超声和CT在直肠癌术前分期中的个人经验。我们的系列研究包括64例（38例男性和26例女性）接受直肠内超声检查的患者；其中38例患者还接受了下腹部CT检查。使用这两种成像技术对直肠壁及相邻结构的浸润情况和淋巴结受累情况进行了研究。我们的研究结果涉及58例接受直肠内超声检查的患者，其中31例也接受了CT检查。关于超声检查的T参数，获得了41例正确诊断，13例病变分期过高，4例分期过低。敏感性、特异性和诊断准确性分别为89.5%、60%和79.3%。CT检查有23例诊断正确，1例病变分期过高，7例分期过低；关于直肠壁浸润的敏感性、特异性和诊断准确性分别为72%、83.3%和74.2%。对N参数的评估显示，超声（15.8%）和CT（42.9%）的敏感性都较低。考虑到我们系列研究的结果，我们认为有必要同时使用这两种成像技术，因为尽管N参数意义不大，但就T参数而言，所获得的结果是互补的。
