CT與MRI診斷結(jié)腸癌致腸梗阻的應(yīng)用價(jià)值研究

陳桂泉　廖余勝 黃凱清　費(fèi)西平　魏吉祥

【摘要】 目的：探討CT與MRI診斷結(jié)腸癌致腸梗阻的應(yīng)用價(jià)值。方法：選擇筆者所在醫(yī)院2017年6月-2019年6月收治的50例結(jié)腸癌致腸梗阻患者，依次采用CT和MRI進(jìn)行檢查，對(duì)比兩種方式檢查的效果。結(jié)果：MRI檢出率為100%，無(wú)漏診，CT檢出率為90.00%，漏診率為10.00%，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。MRI對(duì)于腫塊侵犯漿膜下、狹窄段、腸旁組織缺血性結(jié)腸炎檢出率高于CT（P<0.05）。T1WI圖像顯示腫塊呈等低信號(hào)，局部管腔狹窄;T2WI-SPAIR圖像顯示乙狀結(jié)腸累及漿膜下;MRI增強(qiáng)圖像顯示乙狀結(jié)腸明顯不均勻強(qiáng)化。結(jié)論：CT與MRI在結(jié)腸癌致腸梗阻的診斷中，MRI的應(yīng)用價(jià)值更高，MRI對(duì)于侵犯漿膜下、狹窄段、腸旁組織缺血性結(jié)腸炎等檢出率高于CT，診斷準(zhǔn)確率高，漏診率低，值得臨床推廣使用。

【關(guān)鍵詞】 CT MRI 結(jié)腸癌 腸梗阻 診斷價(jià)值

doi：10.14033/j.cnki.cfmr.2020.16.027 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805（2020）16-00-03

Application Value of CT and MRI in Diagnosing Intestinal Obstruction Caused by Colon Cancer/CHEN Guiquan， LIAO Yusheng， HUANG Kaiqing， FEI Xiping， WEI Jixiang. //Chinese and Foreign Medical Research， 2020， 18（16）： -71

[Abstract] Objective： To explore the application value of CT and MRI in the diagnosis of intestinal obstruction caused by colon cancer. Method： Fifty patients with colon cancer-induced intestinal obstruction treated in our hospital from June 2017 to June 2019 were selected and examined by CT and MRI in order. And the effects of the two methods were compared. Result： The MRI detection rate was 100%， there was no missed diagnosis， the CT detection rate was 90.00%， and the missed diagnosis rate was 10.00%. There was a statistically significant difference between the groups （P<0.05）. The detection rate of MRI for ischemic colitis of masses invading the subserosal， stenotic and para-intestinal tissues were higher than those of CT （P<0.05）. On T1WI， the mass showed isolow signal and local lumen was narrow. On T2WI-spair， the sigmoid colon was involved in subserosal. On MRI， the sigmoid colon was significantly enhanced unevenly. Conclusion： CT and MRI are more valuable in the diagnosis of colon cancer-induced intestinal obstruction. MRI has a higher detection rate for invasion of subserosal， stenotic， and intestinal ischemic colitis than CT， and the diagnosis is accurate. The high rate and low rate of missed diagnosis are worthy of clinical promotion.

[Key words] CT MRI Colon cancer Intestinal obstruction Diagnostic value.

First-authors address： Nanhai Hospital of Southern Medical University， Foshan 528244， China

結(jié)腸癌是消化道常見(jiàn)腫瘤性疾病，惡性程度高，對(duì)患者生命健康造成嚴(yán)重影響[1]。結(jié)腸癌近年來(lái)發(fā)病率呈現(xiàn)上升趨勢(shì)，僅次于胃癌、食管癌，尤其是中老年人高發(fā)，主要與人口老齡化和不良的飲食生活方式存在一定的關(guān)系[2]。癌癥進(jìn)一步進(jìn)展可以侵犯累積周圍組織，出現(xiàn)腸梗阻，表現(xiàn)為便秘、腹瀉交替的癥狀，嚴(yán)重困擾患者的正常生活[3]。早期診斷并治療對(duì)于患者的臨床預(yù)后意義重大。CT與MRI是臨床常用的檢查方式，對(duì)于結(jié)腸癌致腸梗阻具有一定的診斷作用[4]。本研究旨在探討CT與MRI在診斷結(jié)腸癌致腸梗阻的應(yīng)用及價(jià)值。

1 資料與方法

1.1 一般資料

本研究納入筆者所在醫(yī)院2017年6月-2019年6月收治的50例結(jié)腸癌致腸梗阻患者。納入標(biāo)準(zhǔn)：患者臨床上確診結(jié)腸癌致腸梗阻，病歷資料齊全。排除標(biāo)準(zhǔn)：（1）合并其他可能影響研究結(jié)果的疾病，如肺癌、肝癌、白血病、淋巴瘤等腫瘤性疾病的患者;（2）合并嚴(yán)重的凝血功能障礙性疾病的患者;（3）合并精神分裂癥、重度抑郁、重度躁狂等精神障礙性疾病的患者;（4）合并嚴(yán)重的肝腎功能障礙的患者;（5）對(duì)造影劑過(guò)敏的患者。……