Accuracy of water-enema multidetector computed tomography (WE-MDCT) in colon cancer staging: a prospective study

被引:23
|
作者
Sibileau, E. [1 ]
Ridereau-Zins, Catherine [1 ]
Vanel, D. [2 ]
Pavageau, A. H. [3 ]
Bertrais, S. [4 ]
Metivier-Cesbron, E. [5 ]
Venara, A. [6 ]
Aube, C. [1 ]
机构
[1] LUNAM Univ, Univ Hosp Angers, Dept Radiol, Angers, France
[2] Ist Rizzoli, Res Dept, Bologna, Italy
[3] LUNAM Univ, Univ Hosp Angers, Cellular & Tissue Pathol Dept, Angers, France
[4] LUNAM Univ, Univ Hosp Angers, HIFIH Lab, UPRES 3859,SFR 4208, Angers, France
[5] LUNAM Univ, Univ Hosp Angers, Liver Gastroenterol Dept, Angers, France
[6] LUNAM Univ, Univ Hosp Angers, Dept Visceral Surg, Angers, France
来源
ABDOMINAL IMAGING | 2014年 / 39卷 / 05期
关键词
Colon cancer; Tumoral staging; WE-MDCT; COLORECTAL-CARCINOMA; SPIRAL CT; STRATEGIES; FEATURES; SURGERY; SYSTEM; TOOL;
D O I
10.1007/s00261-014-0150-9
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
To assess the accuracy of water-enema multidetector computed tomography (WE-MDCT) in extra-rectal colon cancer staging. Fifty-three patients (mean age 70 years) with extra-rectal colon cancer proven by colonoscopy and biopsy were prospectively evaluated by preoperative WE-MDCT. CT scans were both intraluminal (water enema or WE) and intravenous (iodinated) contrast enhanced (CE). All patients underwent surgery. Tumors were classified with the TNM staging system. Noted CT features were: tumor size and location; tumor form and edges; spread to the pericolic fat or neighboring organs; thickening of retroperitoneal fascia; number, size, and enhancement of the peritumoral lymph nodes. Tumors were classified on CT into 3 T-stage groups: T1/T2, T3, and T4. Lymph nodes were classified by their density after injection [positive over 100 Hounsfield units (HU)]. Tumor localization to the specific colon segment was correct in all the cases. The agreement between WE-MDCT staging and histopathology staging was good (k = 0.64). An irregular and bowl-shaped aspect of the external edges of tumor provided excellent sensitivity for T3/T4 inclusion (Se 97.7%, NPV 85.7%). Thickening of a fascia or the abdominal wall provided good specificity for T4 stage (Sp 88.1%, NPV 94.9%). Enhancement over 100 HU of at least one peritumoral lymph node was the best criterion of N+ staging (Sp 67.7%, NPV 87.5%). WE-MDCT permits good staging of colon cancer based on objective features.
引用
收藏
页码:941 / 948
页数:8
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