Application Of Multi-slice Spiral CT In Preoperative Evaluation Of Rectal Carcinoma

Objective To study the application value of multi-slice spiral CT(MSCT)in preoperative evaluation of anus-preserving,operation mode,the resectability of laparoscopic for rectal carcinoma preoperative examination before surgery.Metheds Clinical materials of 146 patients with colonoscopy and clinical proved rectal carcinoma were recruited.MSCT were performed with plain and triphasic dynamic contrast enhancement before surgery.Evaluate the distance from the tumor to the anal verge;the local lymph nodes metastasis;the invaded of surrounding organs;rectal sphincter by rectal carcinoma;tumor size?location,and peritoneal adhesions.Taking the results of surgical operation,the diagnostic efficiency of preoperative evaluation using MSCT was studied.And the consistency analysis between MSCT and surgical operation results was performed.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MSCT preoperative evaluation of anus-preserving was94.12%(96/102),57.14%(16/28),86.15%(112/130),88.89%(96/108),72.73%(16/22),respectively.Preoperative evaluation outcome of anus-preserving using MSCT was mainly consistent with surgical operation(K=0.57,?~2=41.06,P<0.05).130 cases accepted surgical treatment:3 cases of transanal local excision,28 cases of Miles operation,3 cases of Hartmann operation,96 cases of Dixon.Preoperative evaluation of MSCT: 33 cases of Miles,4 cases of Hartmann,88 cases of Dixon,5cases of local excision of the anus.The accuracy on MSCT preoperative evaluation was 84.62%.MSCT preoperative evaluation consistency was consistent with postoperative outcome(K=0.653??~2=225.352?P<0.05).There were 85 cases in laparoscopic treatment group: 40 cases of laparoscopicsurgery;32 cases of tradition open surgery.The accuracy of MSCT preoperative evaluation was 80.56%.MSCT preoperative evaluation consistency was consistent with postoperative outcome(K=0.601??~2=26.372?P<0.05).Conclusion 1?MSCT can be used in preoperative evaluation of anus-preserving and Operation mode for rectal carcinoma patients with high accuracy.It can be provide important basis for clinical surgical treatment evaluation.2 ? MSCT can be used in preoperative evaluation of the resectability for laparoscopic rectal carcinoma operations with high accuracy and provide important significance for preoperative evaluation.