ISSN 1004-4140
CN 11-3017/P

多层螺旋CT对结肠癌淋巴结转移的诊断价值

The Diagnostic Value of Multislice Spiral CT in Lymph Node Metastasis of Colon Cancer

  • 摘要: 目的:初步评判多层螺旋CT淋巴结短长径比值联合相对强化值对结肠癌淋巴结转移的诊断价值。方法:收集我院肿瘤外科经结肠镜或手术病理确诊的结肠癌患者47例作为研究对象,进行腹部CT平扫和增强扫描。记录腹部可疑淋巴结短径、短-长径比值、平扫和动、静脉期CT值以及相对强化值各项参数,并以病理结果为金标准,进行ROC曲线绘制,并分析上述各个参数的诊断效能。结果:结肠癌转移淋巴结的短径、短长径比值、平扫和动、静脉期CT值以及相对强化值与非转移淋巴结比较均明显升高(P<0.01)。短径、短-长径比值、平扫和动、静脉期CT值以及相对强化值所绘制ROC曲线AUC分别为0.649、0.725、0.713、0.723、0.696和0.793,灵敏度分别为63.30%、76.70%、73.30%、60.00%、76.72%和73.30%,特异度分别为75.00%、70.00%、60.00%、75.00%、65.00%和90.00%;淋巴结短长径比值联合相对强化值ROC曲线AUC为0.908,敏感度为86.70%,特异度为85.00%,一致性分析显示Kappa系数为0.787,提示有较好的一致性。结论:多层螺旋CT淋巴结短-长径比值联合相对强化值对结肠癌淋巴结转移具有较高的特异度,可为临床判断淋巴结转移提供重要依据。

     

    Abstract: Objective: To evaluate the value of short-to-long-diameter ratio(SLR) combined with relative enhancement in the diagnosis of lymph node metastasis of colon cancer. Methods: 47 cases of colon cancer diagnosed by surgery in our hospital were analyzed retrospectively. All patients underwent plain abdominal CT scan and enhanced CT scan. The parameters of short diameter, ratio of short to long diameter, CT value and relative enhancement value of abdominal suspicious lymph nodes were recorded. The results were compared with each other. ROC curve was drawn to analyze the diagnostic value of each parameter. Results: compared with non-metastatic lymph nodes, the value of short diameter, short-to-long diameter ratio, CT value of plain scan, arterial and venous phase and relative enhancement value of metastatic lymph nodes were significantly increased(P<0.01). The ROC curves were 0.649, 0.725, 0.713, 0.723, 0.696, 0.793 for short diameter, ratio of short to long diameter, CT value of plain scan, arterial and venous phase and relative enhanced value, respectively, the sensitivity was 63.30%, 76.70%, 73.30%, 60.00%, 76.72%, 73.30%, and the specificity was 75.00%, 70.00%, 60.00%, 65.00%, 90.00% respectively, the sensitivity and specificity were 86.70% and 85.00%, respectively. The Kappa Coefficient was 0.787. Conclusion: The short-to-long-diameter ratio(SLR) combined with the relative enhanced value of MSCT has high sensitivity to lymph node metastasis of colon cancer, which can provide important evidence for clinical diagnosis of lymph node metastasis.

     

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