目的 探讨CT平扫与增强扫描在 结直肠癌切除术术前术后评估中的临床应 用价值分析。方法 选取2014年3月-2015 年4月我院经纤维结肠镜和病理活检确诊 为结直肠癌的患者75例，所有患者均于术 前接受CT平扫加增强扫描，将原始横断面 等图像进行结合并且与手术病理进行分 析比较；比较CT平扫与对比增强扫描对 结直肠癌周围结构的显示情况分析，并 计算直肠癌T、N分期的灵敏度、特异度、 准确率。结果 75例患者CT检查对照手术 病理诊断定位定性准确率100%。75例患者 以病理结果为基准，螺旋CT多期扫描结 果显示：T分期诊断符合率为65.33%，灵 敏度为76.28%，特异度为64.39%，诊断 准确率为71.50%，阳性预测值为79.83%， 阴性预测值为62.24%。N分期诊断符合率 为62.67%，灵敏度为72.35%，特异度为 67.76% ，诊断准确率为62.23%，阳性预 测值为65.71%，阴性预测值为64.55%。CT 术前平扫可见结肠管壁明显增厚；CT术前 增强扫描动脉期肠壁中等程度强化，静脉 期、延迟期肠壁强化程度减低，呈轻度强 化；CT术后平扫可于结肠见金属缝合线 影，吻合口处管壁未见明显增厚。结论 CT平扫与增强扫描可以为结直肠癌术前进 行更准确的TNM分期，且能显示术后的缝 合情况，在结直肠癌切除术术前术后评估 中具有较高的临床应用价值。

Objective To investigate the clinical value of CT plain scan and enhanced scan in preoperative and postoperative evaluation of colorectal cancer resection. Methods From March 2014 to April 2015 in our hospital, 75 cases of colorectal cancer diagnosed by colonoscopy and pathological biopsy, all patients underwent CT plain scan and enhanced scan before operation. The original cross sectional images were combined and compared with surgical pathology. CT plain scan and contrast enhanced scan were used to analyze the display of the surrounding structures of colorectal cancer, and the sensitivity, specificity and accuracy of T and N staging of rectal cancer were calculated. Results The accuracy rate of CT examination in 75 cases was 100%.75 patients with pathological results as reference, spiral CT scan showed that the T stage diagnostic coincidence rate was 65.33%, the sensitivity was 76.28%, specificity was 64.39%, the diagnostic accuracy was 71.50%, the positive predictive value was 79.83%, the negative predictive value was 62.24%. The diagnostic accuracy of N staging was 62.67%, the sensitivity was 72.35%, the specificity was 67.76%, the diagnostic accuracy was 62.23%, the positive predictive value was 65.71%, and the negative predictive value was 64.55%. Preoperative CT scan shows colon tube wall thickening. CT preoperative enhanced arterial phase of intestinal wall enhanced moderately, venous phase and delayed phase enhancement of intestinal wall wall decreased, and slight enhancement; after CT scan can be seen in the colon metal suture shadow, anastomotic wall thickening was not obvious. Conclusion CT scan and enhanced scan for colorectal cancer preoperative TNM staging is more accurate, and can display the suture after operation, resection of preoperative and postoperative assessment has high clinical value in colorectal cancer.