The Clinical Value Of Dual-source CT In The Diagnosis Of Colorectal Cancer

Objective： To study the correlation between the DECT colorectal cancer iodineconcentration and the cancer tissue amount of MVD labeled by CD31; Explore the value ofiodine concentration to judge the tumor invasion and metastasis ability; and evaluationperitumoral fatty iodine concentration on the ability of advanced colorectal carcinomainvading the surrounding fat.Materials and methods: Collection30cases of colorectal cancer patients inZhongnan Hospital2012.1-2012.10were confirmed by colonoscopy biopsy or operationpathologically, including17cases of male,13cases of female, age41-74years old, averageage is about67years old. All cases in the preoperative were underwent conventional plainscan and dual-source CT enhanced scan(50-55s), the data send into the post-processingworkstation for image post-processing and analysis, the iodine concentrations of the lesionand the peritumoral fatty were measured; the pathological tissues of colorectal carcinomawas detected by S-P immunohistochemical method for CD31expression, and countmicrovessel density (MVD). According to the pathological results after operation,30patientswere respectively grouped by serosal invasion and metastasis, analysis the correlation amongiodine concentration and MVD count in each group. Discuss the relationship between iodineconcentration and the ability of tumor serosal invasion, metastasis size; and the relationshipbetween the iodine concentration of peritumoral fatty and fat invasion. Results：In30cases, refer to the postoperative pathological results:20cases of colorectalcancer with serosal invasion，the iodine concentration was2.40±0.44mg/ml,10caseswithout serosal invasion，the iodine concentration was1.97±0.34mg/ml;11cases ofcolorectal cancer with metastasis，the iodine concentration measured was2.56±0.38mg/ml,19cases without metastasis was2.07±0.39mg/ml, both of them had significant difference(P<0.05);10cases of colorectal cancer with intestinal fat invasion，the iodine concentrationof peritumoral adipose was0.75±0.28mg/ml,20cases without peri-bowels fatinfringement，the iodine concentration was0.11±0.11mg/ml, the difference was statisticallysignificant (P<0.05). Pearson correlation analysis showed: the lesion iodine concentrationwas positively correlated with MVD counts (P<0.01). By using the software of SPSS18Softwara ROC curve method to select the best sensitivity and specificity threshold: theiodine concentration of the serosa group，when the threshold value was2.05mg/ml,thesensitivity was75%，the specificity was70%；the iodine concentration of the transfer group，when the threshold value was2.25mg/ml，the sensitivity was81.8%,the specificity was78.9%；the peritumoral fat iodine concentration of fatty infiltration group: when theboundary value was0.25mg/ml，the sensitivity was100%,the specificity was86.4%。Conclusion: The dual source CT iodine content was positively correlation with MVDcount;the peritumoral fatty iodine content was measured is helpful to judge the ability of fatinvasion. Iodine map can be a tool help to assessment of local l invasion and metastasis ofthe colorectal cancer.