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目的:探讨经直肠双平面超声联合超声造影在直肠癌术前T分期中的价值。方法:回顾性分析新疆医科大学第一附属医院2014年3月至2015年3月75例经病理确诊直肠癌患者术前行经直肠双平面超声(TRUS)联合超声造影检查及多层螺旋CT检查(MSCT),观察肿瘤的位置,边界,内部回声,造影后的增强模式及肿瘤的内部微循环灌注,在MSCT扫描下的直肠壁的厚度改变及密度变化,分别将诊断结果与术后病理结果进行对照。结果:术前经直肠双平面超声联合超声造影检查对直肠癌T分期总准确率为84%,T_1、T_2、T_3、T_4期的灵敏度分别为75%、75%、97.1%、66.7%,特异度分别为100%、92.7%、82.1%、98.5%;MSCT诊断直肠癌的总准确率为46.7%,T_1、T_2、T_3、T_4期的灵敏度分别为8.3%、60%、47.2%、71.4%,特异度分别为100%、50.9%、74.3%、95.5%,两者差异有统计学意义(P<0.05)。结论:经直肠双平面超声联合超声造影能清晰的观察肿瘤侵犯直肠肠壁层次,肿瘤内部微循环及血流供应,在直肠癌的术前T分期中有着较为明显的诊断优势。
Objective: To investigate the value of transrectal bi-plane ultrasound combined with contrast-enhanced ultrasound in preoperative T-staging of rectal cancer. Methods: Retrospective analysis of 75 cases of pathologically confirmed rectal cancer patients from March 2014 to March 2015 in the First Affiliated Hospital of Xinjiang Medical University was retrospectively analyzed by transrectal dual-plane ultrasound (TRUS) combined with contrast-enhanced ultrasound and multi-slice spiral CT MSCT) were used to observe the location of tumor, border, internal echo, enhancement pattern after angiography and internal microcirculation perfusion of tumor. Thickness and density changes of rectal wall under MSCT scan were performed. The diagnostic results were compared with postoperative pathological results Control. Results: The total accuracy of preoperative transrectal bi-planar ultrasound combined with contrast-enhanced ultrasonography was 84% for T-staging of rectal cancer and 75%, 75%, 97.1% and 66.7% for T_1, T_2, T_3 and T_4 respectively The overall accuracy of MSCT in diagnosis of rectal cancer was 46.7%. The sensitivity of T 1, T 2, T 3 and T 4 were 8.3%, 60%, 47.2% and 71.4% respectively, , Specificity were 100%, 50.9%, 74.3%, 95.5% respectively, with significant difference between the two groups (P <0.05). Conclusion: Transrectal bi-plane ultrasound combined with contrast-enhanced ultrasound can clearly observe the tumor invasion of the rectal wall, microcirculation and blood flow in the tumor, which has obvious diagnostic advantages in the preoperative T stage of rectal cancer.