结肠癌螺旋CT与超声诊断比较分析

Comparison between Spiral CT and Ultrasound in Diagnosing Colon Cancer

  • 摘要: 探讨结肠癌螺旋CT与超声的诊断价值。方法:将65例结肠癌的术前螺旋CT、超声诊断及其中29例钡灌肠造影诊断,分别与术后病理诊断进行对比分析,探讨螺旋CT与超声的诊断价值。结果:螺旋CT、超声诊断结肠癌与病理相符分别为55例和50例,诊断符合率分别为84.6%和76.9%;29例钡灌肠造影,23例与病理诊断相符,符合率79.3%;而螺旋CT+超声2种检查方法结合应用分析,与术后病理相符共64例,诊断符合率98.5%。螺旋CT、超声、钡灌肠造影诊断结肠癌3种方法比较,差异无统计学意义(χ2=1.257,P>0.05)。而螺旋CT+超声2种检查,分别与3种方法中的任何一种检查方法比较均有显著性差异(与螺旋CT比较:χ2=4.424,P<0.05;与超声比较:χ2=6.985,P<0.01;与钡灌肠比较:χ2=7.379,P<0.01)。手术病理证实淋巴结转移34例,术前螺旋CT、超声、螺旋CT+超声诊断分别为25、17、29例。螺旋CT与手术病理对照差异有显著性差异(χ2=4.626,P<0.05);超声与手术病理对照差异有显著性差异(χ2=12.705,P<0.005);螺旋CT+超声与手术病理对照差异无显著意义(χ2=2.186,P>0.05)。结论:螺旋CT、超声、钡灌肠造影诊断结肠癌3种检查方法,无优劣之分,但螺旋CT与超声2种方法结合应用,会明显提高结肠癌的诊断率和淋巴结转移诊断率。

     

    Abstract: To investigate the diagnostic value of spiral CT and ultrasound for colon cancer. Methods: Preoperative spiral CT and ultrasound diagnoses in 65 colon cancer cases, of which 29 were also diagnosed with barium enema, were compared with the results of postoperative pathology to further assess the diagnostic values of the CT and ultrasound methods. Results: Spiral CT and ultrasound diagnoses were respectively consistent with the pathology in 55 and 50 of the colon cancer cases, with a diagnostic accordance rate of 84.6% and of 76.9% in the two groups, respectively. The diagnostic results of barium enema in 23 of the 29 cases was consistent with the pathological results, with a diagnostic accordance rate of 79.3%. The results of 64 cases diagnosed by a combined spiral CT and ultrasonography diagnoses were consistent with the pathological diagnosis, with a diagnostic accordance rate of 98.5%. Statistical results indicated no statistical significance among the three methods ( χ2 = 1.257, P > 0.05 ). A statistical significance was obtained in the combined spiral CT and ultrasound examination, compared with any of the three previous methods, that was, with spiral CT: χ2 = 4.424, P < 0.05, with ultrasound: χ2  = 6.985, P < 0.01, and with barium enema: χ2 = 7.379 , P < 0.01. The diagnostic results of surgical pathology confirmed that lymph node metastasis occurred in 34 cases. The results of the preoperative spiral CT, ultrasound, and the combined examination of spiral CT and ultrasound showed that nodal metastasis occurred in 25, 17, and 29 cases, respectively. For the diagnosis of lymph node metastasis, there was significant difference between the spiral CT and surgical pathology, χ2 = 4.626, P < 0.05. Statistical significance was also obtained between the ultrasound and pathological results, χ2 = 12.705, P < 0.005, whereas that between the outcome of the combined method and pathology was not statistically significant, χ2 = 2.186, P > 0.05. Conclusion: There are differences in the diagnoses of colon cancer among spiral CT, ultrasound, and barium enema. However, combined spiral CT and ultrasound diagnoses will significantly improve the diagnostic rate of the cancer and the diagnostic accuracy of lymph node metastasis.

     

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