大肠癌的螺旋CT三维重建研究及外科应用评价

目的 :探讨螺旋CT三维重建技术在大肠癌外科术前诊断中的价值。材料和方法 :选 2 0例有低张气钡灌肠造影及病理证实的大肠癌 ,行低张充气螺旋CT扫描 ,表面覆盖显示 (SSD)、容积漫游技术 (VRT)、多平面重组 (MPR)等三维重建 ;另 10例行常规及低张注生理盐水CT检查。本法与造影、常规CT、低张注水CT及手术、病理对照观察。结果 :常规CT检出率为 4/ 10 ;低张注水CT检出率为 7/ 10 ;低张气钡灌肠造影检出率为 2 0 / 2 0 ;螺旋CT三维重建检出率为 2 0 / 2 0。前三者在检出率或观察内容上均有各自限度 ,后者可弥补。结论 :SSD、VRT可显示 6mm隆起病变和 3mm管腔狭窄 ,VRT可显示 1mm细沟凹陷 ;MPR对轻微的肠壁增厚、僵硬很敏感 ,能准确判断病灶外侵程度 ;SSD酷似内窥镜 ,VRT可比低张气钡灌肠造影 ,SCT三维重建可一法多用。

The Evaluation and Application of Spiral CT with 3D-Reconstruction in Colorectal Carcinoma

Purpose:To evaluate the techniques of three-dimensional (3D) reconstruction with spiral CT and the value of preoperative diagnosis in colorectal carcinoma. Materials and Methods:Twenty cases of colorectal carcinoma proved by double-contrast barium enema examination and pathology were examed by spiral CT using low tension and gas filling, then the CT images were reconstructed using shaded surface display (SSD), volume rendering technique (VRT) and multi planar reconstruction (MPR); the other ten cases examed by common and water enema spiral CT (WESCT). Then compared with X-ray plain, common CT, water enema spiral CT(WESCT), operation and pathology. Results:The accuracy rate of common CT was 4/10 and WESCT was 7/10, but double-contrast barium enema examination and 3D reconstruction of SCT were 20/20. 3D reconstruction of SCT could remedy the limitations of other methods in accuracy rate and observing content. Conclusion:SSD and VRT could show more than 6mm-protrusion lesions and more than 3mm lumen stenosis. VRT could show only 1mm tiny hollow. MPR is very sensitive for finding the slight thickening bowel wall and stiffness, also could judge exactly the exterluminal involvement. SSD is like doing endoscopic, VRT could match with the double-contrast barium enema examination, so SCT with 3D images is recognized as a useful technique for diagnosis of colorectal carcinoma.