| Objective:Methods a retrospective case control study was used.To investigate the CT features of tumor deposition in colorectal cancer,and to provide the basis for differential diagnosis.Methods:The clinical and pathological data of 26 patients with colorectal cancer from May 2005 to April 2017 were collected from Wuxi Second Hospital of Nanjing Medical University from May 2005 to April 2017.Patients underwent preoperative multi-slice spiral CT scan and double-phase enhanced scan,and received surgical treatment.Observe indicators:(1)CT imaging features: primary tumor site,tumor deposition number,location,shape,size,CT value,density.(2)Identification comparison : Tumor deposition and metastatic lymph node morphology,size comparison,comparison of CT values of tumor deposition,metastatic lymph node and primary tumor.(3)Follow-up.The normally distributed measurement data is represented by x± s,tumor deposition and lymph node were compared by t test,tumor deposition,metastatic lymph node,primary tumor were compared using single factor analysis of variance,comparison between the two was using SNK method.Follow-up by telephone,once every three months;follow-up content for the prognosis of patients,follow-up time as of 2017 May.Results(1)CT imaging features:In 26 cases,17 cases underwent double contrast enhanced scan of chest,abdomen and pelvic,and 9 cases underwent abdominal and pelvic double contrast scan;Primary tumor site occurred in the colon in 18 cases,8 cases of rectum.In 26 cases,41 tumor deposits were collected,the number of tumor deposits in a single case was(1.6 ± 0.9)(1-4),in 20 cases were < 3,in 6 cases were ? 3;Tumor deposits are often isolated in the fat Spaces around the rectum or colon,discontinuous with the surrounding primary tumor or lymph node,the distance from the center of the tumor was(2.6±1.03)cm(0.2-5.0 cm),the distance was <2.6 cm in 22 cases,?2.6 cm in 19 cases;Of these 33 tumors showed signs of lobulated,22 tumors showed burr,and 7 tumor deposits showed liquefaction necrosis.The length,diameter and maximum diameter of the tumors were(1.15 ± 0.60)cm,(1.11±0.44)cm,and(1.13±0.49)cm in 41 tumor deposits;the values of CT scan,arterial phase CT enhancement and CT enhancement in venous phase were(27±13)Hu,(28±14)Hu,and(49±19)Hu.41 tumor deposition,34 plain scan density was uniform,enhanced scan was early to strengthen significantly,and was evenly enhanced,of 7 was inhomogeneous,the internal liquefaction necrosis was observed,the enhanced scan necrosis area was not enhanced,and the non necrotic area was enhanced early.(2)Identification comparison:in this study,a total of 19 metastatic lymph nodes verified by pathology were collected from the primary tumor center 5cm.Of the 41 tumor deposits,33 were irregular in shape and 8 in shape or round in shape or oval in shape;Of the 19 metastatic lymph nodes,16 of them were round in shape,1 irregular in shape and obscure in edge,and 2 of them were irregular in shape and fused with each other..There were statistical differences between the length of tumor deposition,the length of metastatic lymph node,the short diameter and the maximum diameter(F = t =5.48,4.80,7.75,P< 0.05).There were significant differences between the scan of tumor deposit,metastatic lymph node,primary tumor,scan CT value and CT enhancement value during arterial phase(F = 24.43,4.46,P< 0.05),there was no significant difference in CT enhancement between the three,(F = 2.41,P> 0.05).Among them,tumor deposition and metastatic lymph node scan,CT value,arterial phase CT enhancement value were compared,the differences were statistically significant(q = 5.48,2.50,P< 0.05);The CT scan of metastatic lymph node and primary tumor and the value of CT enhancement in arterial phase were statistically significant(q = 6.82,2.84,P< 0.05);There was no statistical difference between the tumor deposit and the CT scan of primary tumor and the enhancement value of arterial phase CT(q =2.15,0.65,P> 0.05).Among the 19 metastatic lymph nodes,11 were flat scan,the density was homogeneous,the density was lower than the tumor deposition and the primary tumor,and the enhanced scan arterial phase enhanced value was smaller than the tumor deposition,and showed relatively homogeneous enhancement;the scan density of the 8 metastatic lymph nodes was inhomogeneous,and there was liquefaction necrosis in the interior,the enhanced scan showed "annular enhancement",and there was no enhancement in the necrotic region.The density of tumor deposition not only was similar to the primary tumor density,but also was similar to that of primary tumor in the extent of enhancement of arteriovenous.(3)Follow-up:24 patients were followed up for 1-25 months,the follow-up rate was 92.3%.The median follow-up time was 17 months.There were 2 deaths during the follow-up period,and the overall survival time was 21 months and September months respectively.Conclusion:Multislice spiral CT examination of tumor deposits is larger and irregular,it can be seen the image features of lobulated and burr,the scan density was near to the primary tumor,and the early enhancement of arterial scan was obvious,its morphology,size and CT value provide a reliable basis for differential diagnosis of lymph nodes. |
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