ACCURACY OF COMPUTED TOMOGRAPHY IN CHARACTERISATION OF COLORECTAL LESIONS AS BENIGN OR MALIGNANT AND IN PRE-OP STAGING OF COLORECTAL CARCINOMA WITH HISTOPATHOLOGICAL CORRELATION

Deepika Nair, Rinku Mercy Thomas
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Abstract

Objective-To determine the accuracy of Multi Detector CT in characterizing colorectal lesions as benign or malignant - and its correlation with histopathology by studying bowel wall characteristics. - Methods 55 patients referred to the Department of Radiodiagnosis at a tertiary care centre in Trivandrum for contrast CT abdomen who had abnormal bowel wall thickening on CT. Lesions are classied on CT as benign or malignant based on bowel wall characteristics of wall thickening and staging is done in case of colorectal carcinoma. The ndings are then compared with the histopathological diagnosis. Results- Overall, CT had a sensitivity of 94.9%, specicity of 93.8%, Positive Predictive Value of 97.4% and a Negative Predictive Value of 88.2% in the diagnosis of malignant lesions. Accuracy of CT in diagnosing malignant lesions is 94.5%. Positive likelihood ratio is 15.2. and negative likelihood ratio is 0.05.CT is an excellent modality for tumour (T) staging in colorectal malignancy, as per our study, K=0.806 (excellent agreement).CT, though not highly accurate, can be used for lymph nodal (N) staging in colorectal malignancy, as per our study, K= 0.213 (fair agreement). Conclusion- Due to its high sensitivity and specicity, MDCT is an excellent modality in the diagnosis and differentiation of benign and malignant lesions of the colon and rectum,.It offers early detection of colorectal malignancy, provides staging of malignancies, helps in detection of metastasis, thereby aiding in the choice of treatment strategy. CT is an excellent modality for tumour (T) staging in colorectal malignancy, as per our study, K=0.806 (excellent agreement).
计算机断层扫描在确定结直肠病变是良性还是恶性以及结直肠癌术前分期与组织病理学相关性方面的准确性
目的-通过研究肠壁特征,确定多探测器 CT 将结肠直肠病变定性为良性或恶性的准确性及其与组织病理学的相关性。- 方法 55 名转诊至特里凡得琅市一家三级医疗中心放射诊断部接受腹部对比 CT 检查的患者,这些患者在 CT 上发现肠壁异常增厚。根据肠壁增厚的特征,CT 将病变分为良性和恶性,如果是结直肠癌,则进行分期。然后将  与组织病理学诊断进行比较。结果 - 总体而言,CT 诊断恶性病变的灵敏度为 94.9%,特city 为 93.8%,阳性预测值为 97.4%,阴性预测值为 88.2%。CT 诊断恶性病变的准确率为 94.5%。CT 是结直肠恶性肿瘤(T)分期的极佳方式,根据我们的研究,K=0.806(极好的一致性)。CT 虽然准确性不高,但可用于结直肠恶性肿瘤淋巴结(N)分期,根据我们的研究,K=0.213(一般的一致性)。结论- MDCT 具有高灵敏度和高特异性city,是诊断和鉴别结肠和直肠良恶性病变的绝佳方式。它能早期发现结直肠恶性肿瘤,为恶性肿瘤提供分期,有助于发现转移灶,从而帮助选择治疗策略。CT 是结直肠恶性肿瘤(T)分期的绝佳方式,根据我们的研究,K=0.806(极好的一致性)。
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