| Background and purpose:Colorectal cancer is one of the most common malignant tumor in gastrointestinal tract, and also one of the major diseases threatening human health. According to the world epidemiological survey data show that new cases of colorectal cancer were estimated nearly 1.37 million people in 2014. Which In the third of the incidence of malignant tumor.and in the second place of the mortality malignant tumors. Colorectal cancer has the higher incidence in western countries such as North America, Western Europe, Australia, New Zealand, but the incidence of other countries is relatively low.The morbidity and mortality of colorectal cancer in our country is lower than other common malignant tumor such as stomach cancer, lung cancer, esophageal cancer. However, in recent years the incidence of colorectal cancer in our country is also on the rise,especially in the coastal area is close to or achieve a high incidence of colorectal cancer incidence of level.The biological behavior and invasion and metastasis ability of malignant tumor depends on the degree of tumor histological type and differentiation. and the rearch on it is also the key to accurately judge the degree of tumor progression, prognosis and the key to making treatment plan.Energy spectrum CT is a new functional imaging technology,it provide more and more comprehensive information for the diagnosis of the diseases. In view of this ponit,this study attempts to use energy spectrum CT GSI multi-parameter imaging scan mode to evaluation of spectral imaging in the colorectal cancer pathology types and differentiation degree preoperatively. Materials and methods:Select 52 cases of colorectal disease from April 2014 to August 2012 in the first affiliated hospital of zhengzhou university,and all of the 52 cases confirmed by fibre endoscopicbiopsy or surgical pathology.We should instruct patients with low fat, low fiber, liquid or no residue diets for 2 days before the inspection, fasting for 6 to 12 hours before examination,and at the same time taking oral catharsis agent to empty the intestinal contents until the patients without excrement.the day before the examination should be fasting, patient should drink a full bladder, 30 minutes before the examination.In order to reduce gastrointestinal peristalsis, the dose of 10 mg 654-2 intramuscular injection was needed when patients have to urinate. Through the anus Foley’s intubation, connected patient’s anal with automatic sausage filler,After automatic filler to infuse warm saline colorectal 800-1500 ml(The specific amount of filling the tolerance level as a standard for reasonable adjustment to patients) to make the colorectal fully expansion.All of these 52 patients were under total abdominal scanning with GSI spectrum scan mode. And all the patients has never been antitumor or surgery before GSI scanning.Using GE ADW4.4 workstation spectroscopy spectrum analysis software to make spectrum image analysis.All the data measured for three times and take the average.The following measurement indicators including iodine concentration(IC) and normalized iodine concentration(NIC) of lesions and the same layer of aortay during arterial and venous phase.Analysis the energy spectrum curve of data and calculate the slope. Results:1.The IC values and NIC values of mucinous carcinoma(MC)and non mucinous carcinoma(NMC) during arterial phase(11.85±4.52 、 13.97±5.31;0.14±0.06、0.17±0.08)showed that no significant difference(P>0.05).But the IC values and NIC values of MC and NMC(17.97±6.37、22.06±6.41;0.42±0.11、0.51±0.16)(P<0.05)showed that significant difference during venous phase.2.The IC values and NIC values of well /moderate differentiated and poor differentiated adenocarcinoma(13.82±3.81、14.79±6.53;0.17±0.08、0.19±0.06) showed that no significant difference(P>0.05)during the arterial phase.But significant difference can be seen(19.97±5.35l、23.06±6.49;0.48±0.12、 0.63±0.14)(P<0.05) during venous phase.3.The slope rates of MC and NMC(-1.05±0.41、-1.14±0.58)(P>0.05) showed that no significant difference during the arterial phase.But significant difference can be seen(-1.43±0.55、-1.82±0.43)(P<0.05) during venous phase.4.The slope rates of well /moderate differentiated and poor differentiated adenocarcinoma(﹣1.11±0.39、﹣1.20±0.39)(P>0.05) showed that no significant difference,but significant difference(﹣1.67±0.41、﹣2.14±0.54)(P<0.05) were all found in venous phase. Conclusions:1. The IC values and NIC values of Spectral imaging were helpful for distinguishing pathological type and differentiation of colorectal cancer.2.Spectral curve features were helpful for distinguishing different pathological type and differentiation of colorectal cancer.3.Spectrum CT has a certain clinical value in distinguishing pathological type and differentiation degree of colorectal cancer. |
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