CT與MRI診斷結腸癌致腸梗阻的應用價值研究

陳桂泉　廖余勝 黃凱清　費西平　魏吉祥

【摘要】 目的：探討CT與MRI診斷結腸癌致腸梗阻的應用價值。方法：選擇筆者所在醫院2017年6月-2019年6月收治的50例結腸癌致腸梗阻患者，依次采用CT和MRI進行檢查，對比兩種方式檢查的效果。結果：MRI檢出率為100%，無漏診，CT檢出率為90.00%，漏診率為10.00%，組間比較差異有統計學意義（P<0.05）。MRI對于腫塊侵犯漿膜下、狹窄段、腸旁組織缺血性結腸炎檢出率高于CT（P<0.05）。T1WI圖像顯示腫塊呈等低信號，局部管腔狹窄;T2WI-SPAIR圖像顯示乙狀結腸累及漿膜下;MRI增強圖像顯示乙狀結腸明顯不均勻強化。結論：CT與MRI在結腸癌致腸梗阻的診斷中，MRI的應用價值更高，MRI對于侵犯漿膜下、狹窄段、腸旁組織缺血性結腸炎等檢出率高于CT，診斷準確率高，漏診率低，值得臨床推廣使用。

【關鍵詞】 CT MRI 結腸癌 腸梗阻 診斷價值

doi：10.14033/j.cnki.cfmr.2020.16.027 文獻標識碼 B 文章編號 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

結腸癌是消化道常見腫瘤性疾病，惡性程度高，對患者生命健康造成嚴重影響[1]。結腸癌近年來發病率呈現上升趨勢，僅次于胃癌、食管癌，尤其是中老年人高發，主要與人口老齡化和不良的飲食生活方式存在一定的關系[2]。癌癥進一步進展可以侵犯累積周圍組織，出現腸梗阻，表現為便秘、腹瀉交替的癥狀，嚴重困擾患者的正常生活[3]。早期診斷并治療對于患者的臨床預后意義重大。CT與MRI是臨床常用的檢查方式，對于結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在診斷結腸癌致腸梗阻的應用及價值。

1 資料與方法

1.1 一般資料

本研究納入筆者所在醫院2017年6月-2019年6月收治的50例結腸癌致腸梗阻患者。納入標準：患者臨床上確診結腸癌致腸梗阻，病歷資料齊全。排除標準：（1）合并其他可能影響研究結果的疾病，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）合并嚴重的肝腎功能障礙的患者;（5）對造影劑過敏的患者。……