目的评价螺旋CT扫描对中晚期直肠癌诊断、分期的价值。方法回顾性分析34例经螺旋CT扫描诊断为中晚期直肠癌并且与纤维肠镜活检及其手术、病理结果对照。结果所有螺旋CT扫描均显示为中晚期直肠癌,主要表现为肠管环形或半环形增厚、局部肿块形成、肠管周围浸润、肠腔狭窄、局部或远处淋巴结肿大(直径≥10mm)及其远处器官转移。按照改良Duke’s分期与病理结果对照,总符合率为70.6%其中B1,B2,C,D分期病例敏感性分别为83.3%,50%,66.7%,78.5%,特异性分别62.5%,44.4%,57.1%,100%;按照TNM分期与病理结果对照T分期总符合率为73.5%,其中T2,T3,T4分期敏感性分别为85.7%,61.5%,78.6%,特异性分别54.5%,66.7%,100%。结论螺旋CT扫描对于中晚期直肠癌的肠周浸润范围、盆腔淋巴结转移特别是远处转移具有较肯定的诊断价值。 Objective To evaluate the value of spiral CT in the diagnosis and staging of advanced rectal cancer. Methods Retrospective analysis of 34 cases of diagnosis of advanced rectal cancer by spiral CT scan and fibroids enteroscopy biopsy and surgical, pathological results of the control. Results All spiral CT scans showed advanced stage rectal cancer. The main manifestations were ring-shaped or semicircular thickening of the intestine, local mass formation, infiltration around the intestine, stenosis of the intestine, swollen lymph nodes (diameter≥10mm) Distant organ metastasis According to the modified Duke’s staging and pathological results, the overall coincidence rate was 70.6%. The sensitivity of stage B1, B2, C and D was 83.3%, 50%, 66.7% and 78.5% respectively, and the specificity was 62.5% and 44.4% 57.1% and 100% respectively. The total coincidence rate of TNM staging and pathological findings in control T staging was 73.5%, of which T2, T3 and T4 staging were 85.7%, 61.5% and 78.6% respectively, with specificity of 54.5% and 66.7% , 100%. Conclusion Spiral CT scan has a definite diagnostic value for the range of intestinal peri-invasive, pelvic lymph node metastasis, especially distant metastasis in advanced rectal cancer.