16排CT结肠三维成像在结肠癌及息肉诊断中的初步研究

Preliminary study of colon carcinoma and polypus with 16 slice CT three-dimensional imaging

关键词:  结肠肿瘤  CT  图像处理，计算机辅助

Key words:  colon carcinoma  CT  Image processing, computer-assisted

摘要:

［目的］初步研究16排螺旋CT三维成像（3D CT）包括表面遮盖显示（SSD）、仿真结肠镜（CTVC）和全景内镜显示（PE）在结肠癌及息肉诊断中的临床应用价值，并与结肠镜及手术病理结果相对照。［方法］使用16排CT进行全结肠扫描，扫描条件：扫描层厚1.25 mm，螺距1.375∶1，转速0.8 s，120 Kv，俯卧位240 mA，仰卧位50 mA，扫描总时间10～14 s。对3种三维成像方法分别进行图像质量、病变检出时间、病变检出率、Borrmann分型等的评价。［结果］16排CT的SSD、CTVC、PE的图像质量均显示满意；CTVC 、PE和SSD的病变检出时间递减，SSD和PE用时最短，为3～5 min，明显快于CTVC；SSD、CTVC和PE的病变检出率递增，1.0～5.0 mm息肉的检出率分别为37.5%、80%、80%；5.0～10.0 mm息肉分别为61.5%、100%、100%；10.0 mm以上息肉均为100%；SSD、PE和CTVC对进展期胃癌Borrmann分型准确率100%，高于结肠镜检86.96%。 ［结论］16排CT三维成像大大提高了图像质量和病变检出能力，在结肠小息肉的诊治中发挥巨大潜能。

Abstract:

［Objective］The purpose of this study is preliminarily to discuss clinical application value of three-dimension imaging with 16-slice CT in diagnosis of colon cancer and colon polypus, including shanded surface display (SSD), CT virtual colonography (CTVC) and PE display, compared with colonoscopy and operation pathology. ［Methods］ Using GE Light-speed Ultra 16-slice CT to perform whole colon scan. Scanning condition:1.25 mm/1.375∶1/0.8 s, 120 Kv, prone 240 mA, supine 50 mA, scan total time 10～14 s. Three-dimensional images of colon cancer and colon polypus were evaluated on the basis of image quality、detectable time of focus、detectable rate of focus、Borrmann type. ［Results］ SSD、CTVC、PE images quality in 16-slice CT are satisfied. CTVC、PE and SSD images decrease in detectable time of focus, among these time of SSD and PE is about 3-5 minute and obvious shorter than CTVC. SSD、CTVC and PE images increase in detectable rate of focus. And detectable rate of focus of 1.0～5.0 mm polypus is 37.5%、80%、80% respectively; that of 5.0～10.0 mm is 61.5%、100%、100% respectively; that of exceeded 10.0 mm all is 100%. Accuracy of SSD、PE and CTVC images for deciding Borrmann type is 100%, higher than colonoscopy which is 86.96%.［Conclusion］Three-dimension imaging with 16-slice CT enormously improves image quality and detectable ability of focus. It would bring into play great potential in countercheck of small colon polypus.