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直肠癌术后局部复发的CT诊断

Diagnosis with CT of Postperative Recurrence of Rectal Carcinoma

  • 摘要: 目的 探讨直肠癌术后复发的CT表现和诊断。方法 对49例直肠癌术后病例作CT扫描计64次。结果 肿瘤复发的CT表现:造瘘术后CT表现为会阴及骶前区肿块,呈结节状或分叶状,骶前脂肪间隙消失;无造瘘术后CT表现新直肠壁增厚伴不规则偏心性肿块,管腔狭窄及闭塞,直肠周围脂肪间隙狭窄移位。结果 手术方式是辨别复发或术后改变的必要前提。术后组织纤维化、愈合的肉芽组织及放疗后纤维化均与复发难以鉴别。必要时行细针穿刺活检。

     

    Abstract: Objective To evaluate the CT finding and diagnosis of postoperative recurrence of rectal carcinoma. Methods 49 postoperative rectal cancer patients were preformed CT scans of 64 times. Results CT scan indicated that cancer relapsed 3 to 84 months after surgery.For patients with colostomy,the CT scan showed nodular or lobulated mass in the areas of perineum and presacralis,as well as loss of presacral fat space.For patients without colostomy.CT finding included thickened rectal wall with unregular proximal tumor,rectal obliteration,rectostenosis and ddisplacement of perirectal fat space. Conclusion For judgring whether cancer relapsed and the postoperative changes on CT film,it was necessary to have information ablut the approach of surgery.Our study suggested it was difficult to differentiate tumor recurrence from fibrosis causeed by surgery of rediotherapy ad granulation tissue.And for some cases,needle biopsy was required.

     

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