MSCT Diagnosis And Staging Of Colonic Carcinoma With Common Bowel Preparation

Objective:To investigate the multi-slice spiral Computed Tomography(MSCT) findings and their role in preoperative staging of colonic carcinoma with common bowel preparation, Compared with pathology results.Methods:Retrospective analysis 60 colonic carcinoma inpatient cases in the Gastrointestinal Surgery Department of the 1st Affiliated Hospital of Shantou University Medical College. Their MSCT scannings were with common bowel preparation. Analyzing their MSCT findings retrospectively, including the invasion, lymph node and long distance organ metastasis. The accuracy of MSCT with common bowel preparation for staging tumors was assessed by comparison with surgical and pathologic findings.Results:①Thickening wall of colon was shown in all 60 cases,massive or nodular changes in 20 cases. 8 cases with enhance scanning, 6 cases were showed as slightly-moderately homogeneous enhancement, while 2 cases were showed as slightly-moderately inhomogeneous enhancemet .②MSCT showed the serosa infiltration and adjacent fat tissue extension, which presented the nodular in the serosa and stripes near the bowel. The sensitivity,specificity,and accuracy of MSCT for evaluating serosa and adjacent fat tissue invasion were 98.25% (56/57), 100% (3/3),98.33% (59/60),respectively.③According to the new standard,MSCT accurately diagnosed lymph nodes metastases.The sensitivity, specificity, and accuracy of MSCT for revealing lymph node metastases were 72.22% (13/18), 90.48% (38/42),85% (51/60), respectively.According to the traditional standard,MSCT diagnosed lymph nodes metastases.The sensitivity, specificity, and accuracy of MSCT for revealing lymph node metastases were 33.33%(6/18), 90.48%(38/42),73.33%(44/60), respectively.④MSCT preoperative T, N(New Standard) and TNM staging had good consistency with postoperative pathologic staging (KT=0.899, P_T=0.000; K_N =0.632,P_N=0.000; K_TNM =0.694,P_TNM=0.000).Conclusions:MSCT is one of the optimal imaging methods in depicting tumor location,size,and morphology,delineating tumor extension,revealing lymph nodes and metastases,and making preoperative tumor staging in patients with colonic carcinoma.