Preoperative T and N staging of colorectal cancer: Accuracy of contrast-enhanced multi-detector row CT colonography - Initial experience
Preoperative T and N staging of colorectal cancer: Accuracy of contrast-enhanced multi-detector row CT colonography - Initial experience
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DOI：
10.1148/radiol.2311021152
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发表时间：
2004-04-01
期刊：
影响因子：
19.7
通讯作者：
Bonomo, L
中科院分区：
文献类型：
--
作者：
Filippone, A;Ambrosini, R;Bonomo, L
目的：评价造影剂增强多排计算机断层扫描（CT）结肠镜检查对结直肠癌术前分期的准确性。材料与方法：41例结直肠癌患者术前行多排CT结肠镜造影。在动脉期（开始延迟35秒）和门静脉期（开始延迟70秒）获得图像。动脉期集中在疑似肿瘤区域，而静脉期包括整个腹部和骨盆。两名放射科医生独立评估肿瘤侵入结肠壁上的深度(T)和区域淋巴结累及(N)的横向CT图像，并结合多平面重建（MPRs）。分歧以协商一致的方式得到解决。将CT表现与病理结果进行比较，作为参考标准。评估敏感性、特异性、准确性、阳性预测值和阴性预测值。使用McNemar试验评估T和N分期准确性的差异。结果：在T分期中，单独评估横向图像的总体准确率为73%，与mpr联合评估时的总体准确率为83%。这一差异并不显著。单纯横切面影像的N分期总体准确率为59%，横切面影像和MPR影像联合的N分期总体准确率为80% （P < 0.01）。结论：多排CT结肠镜造影是一种准确的结肠肿瘤术前局部分期技术。(c) rsna， 2004年。
PURPOSE: To evaluate the accuracy of contrast material-enhanced multi-detector row computed tomographic (CT) colonography for preoperative staging of colorectal cancer.MATERIALS AND METHODS: Forty-one patients with colorectal carcinoma underwent preoperative contrast-enhanced multi-detector row CT colonography. Images were obtained in the arterial (start delay of 35 seconds) and portal venous (start delay of 70 seconds) phases. The arterial phase was focused on the suspected region of neoplasm, whereas the venous phase included the whole abdomen and pelvis. Two radiologists independently evaluated the depth of tumor invasion into the colorectal wall (T) and regional lymph node involvement (N) on transverse CT images alone and in combination with multiplanar reformations (MPRs). Disagreements were resolved by means of consensus. CT findings were compared with pathologic results, which served as the reference standard. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were assessed. Differences in accuracy for T and N staging were assessed by using the McNemar test.RESULTS: In T staging, overall accuracy was 73% when transverse images were evaluated alone and 83% when they were evaluated in combination with MPRs. This difference was not significant. N staging was associated with an overall accuracy of 59% with transverse images alone and 80% with combined transverse and MPR images (P < .01).CONCLUSION: Contrast-enhanced multi-detector row CT colonography is an accurate technique for preoperative local staging of colorectal tumors. (C) RSNA, 2004.