Computed tomographic air-contrast enema imaging for presurgical examination of colon tumors: assessment with colon phantoms and in patients
Computed tomographic air-contrast enema imaging for presurgical examination of colon tumors: assessment with colon phantoms and in patients
复制标题
DOI：
10.1007/s11604-007-0185-8
复制
发表时间：
2008-01-01
影响因子：
--
通讯作者：
Ito, Katsuhide
中科院分区：
文献类型：
--
作者：
Kayashima, Yasuyo;Kimura, Fumiko;Ito, Katsuhide
目的。我们利用计算机断层扫描（CT）灌肠成像技术研究了幻影中结肠壁变形的机制，并评估了患者病理T分期与肠壁变形的关系。材料和方法。我们对36例结肠肿瘤患者进行了多排CT检查。在幻影中，我们比较了双对比钡（DCB）和CT灌肠研究的图像，并比较了CT灌肠研究和实际幻影结构的壁变形。在患者中，我们比较了CT灌肠检查和T分期的壁畸形。来自CT灌肠和DCB研究的图像在幻影中是相同的，所有的剖面图像都显示几何基底凹陷。在患者中，畸形程度随着侵入深度的增加而增加；T分期诊断正确率为82.5%。几何基底压痕和结肠扩张不良是CT灌肠成像中高估T分期的主要原因。虽然CT灌肠成像对T分期的诊断准确性较高，但壁畸形被认为与肿瘤浸润等因素一致。我们建议评估T分期不仅使用CT灌肠成像，还使用其他技术，如虚拟内窥镜、轴向成像和多平面重构成像。
Purpose. We investigated the mechanism of colon wall deformities in phantoms and assessed the relation between pathological T staging and wall deformity in patients using computed tomography (CT) enema imaging.Materials and methods. We performed multidetector-row CT in mass-containing phantoms with no structural deformities and in 36 patients with colon tumors. In the phantoms, we compared images on double-contrast barium (DCB) and CT enema studies, and we compared wall deformities on CT enema studies and the actual phantom structure. In patients, we compared wall deformities on CT enema studies and T staging.Results. Images from CT enema and DCB studies were identical in the phantom, and all profile images showed geometrical basal indentations. In patients, the grade of deformity increased with invasion depth; and the diagnostic accuracy of T staging was 82.5%. Geometrical basal indentation and poor colon expansion were the primary reasons for overestimating T staging on CT enema imaging.Conclusion. Although CT enema imaging allows reasonable diagnostic accuracy of T staging, wall deformity is thought to be consistent with tumor infiltration and other factors. We recommend evaluating T staging using not only CT enema imaging but also other techniques, such as virtual endoscopy, axial imaging, and multi-planar reformation imaging.