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目的对结肠充气造影CT低剂量平扫与常规剂量增强扫描结合应用对结肠癌的诊断价值进行探讨。方法选择2009年3月～2010年7月在某医院收治的结肠癌患者32例,年龄22～64岁,平均41.8岁。采用德国西门子公司生产的SOMATOM Sensation16螺旋CT机。体位:仰卧位;范围:双膈顶至耻骨联合下缘;扫描方向:头一足方向;记录每次扫描的辐射剂量。每例患者的4种图像进行增强对增强、平扫对平扫的图像质量对比,由1位CT主管技师、l位CT诊断主治医师、1位外科副主任医师共同对病灶显示的清晰度和图像的器官等进行评定,分析与诊断由2位高年资CT诊断医师共同进行。结果 CT检出阴性预测值76.9%,阳性预测值95.5%。诊断敏感度93.3%,误漏诊5例,检出大肠病变46例,准确率91.2%,特异度73.3%。结论只有将常规剂量增强扫描与结肠充气造影MSCT低剂量平扫进行相互的结合,才可以进行结肠癌的早期诊治及预后评估。这样做能够不影响分期诊断、定性诊断的检查效果,又能够降低了受检者接受的辐射剂量,是一种具有实用价值的扫描技术。
Objective To evaluate the diagnostic value of combined CT low-dose CT and conventional dose-enhanced scanning in diagnosis of colon cancer. Methods 32 patients with colon cancer who were admitted to a hospital from March 2009 to July 2010 were aged 22-64 years with an average of 41.8 years old. Using SOMATOM Sensation16 spiral CT machine made by Germany’s Siemens. Position: supine; range: double diaphragm top to the lower edge of the pubic symphysis; scanning direction: head and foot direction; record the radiation dose for each scan. Each patient’s 4 images were enhanced contrast enhancement and plain imaging quality compared with plain imaging by a CT chief technician, l CT diagnosis attending physician, a surgeon associate chief physician to show the clarity of the lesion and Images of organs, etc., assessment, analysis and diagnosis by the two high-risk CT diagnosis physicians together. Results The negative predictive value of CT was 76.9% and the positive predictive value was 95.5%. The diagnostic sensitivity was 93.3%, misdiagnosis in 5 cases, colorectal lesions were detected in 46 cases, the accuracy rate was 91.2% and the specificity was 73.3%. CONCLUSIONS: Early diagnosis and prognosis of colon cancer can only be performed by combining conventional dose-contrast enhanced CT and low-dose CT scan of colon gastroscopy. This can not affect the diagnosis of staging, qualitative diagnosis of the test results, but also can reduce the radiation dose received by the subject, is a practical scanning technology.