| 赵晓芳,刘柳,谢亮华,杨萍,雷迅,毛芸.小肠CT造影预测肠切除术用于卵巢癌患者对实现满意减瘤术的必要性[J].中国医学影像技术,2023,39(12):1838~1842 |
| 小肠CT造影预测肠切除术用于卵巢癌患者对实现满意减瘤术的必要性 |
| CT enterography for predicting necessity of enterectomy in ovarian cancer patients for achieving optimal debulking surgery |
| 投稿时间：2023-05-02 修订日期：2023-07-30 |
| DOI：10.13929/j.issn.1003-3289.2023.12.022 |
| 中文关键词: 卵巢肿瘤 小肠CT造影 肠切除术 |
| 英文关键词:ovarian neoplasms computed tomography enterography intestinal resection |
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| 中文摘要: |
| 目的 评估术前小肠CT造影（CTE）预测对卵巢癌（OC）患者行肠切除以实现满意减瘤术（ODS）的必要性的价值。方法 回顾性分析经病理确诊的49例OC术前CTE，其中36例未接受、13例接受新辅助化疗（NACT），根据CTE所示肠管肌层受累长度（L）和周径（C）将OC累及肠道程度分为0~2级[0级：未累及；1级：L<3.0 cm且C<1/3周；2级：L≥3.0 cm （A）或C≥1/3周（B）]，作为判断术中行肠切除的必要性的依据。术后随访至少1年，记录实际手术结果，据以推定理想手术方案；分析CTE预测手术方式与理想手术方案的一致性。结果 针对未接受NACT的36例，以术前CTE显示2级A或B受累预测手术方式与理想手术方案的一致性极好（Kappa=0.852，P<0.001），而以1或2级、2级A、2级B进行预测的结果与理想手术方案的一致性均较好（Kappa=0.684~0.771，P均<0.001）。针对13例接受NACT者，以NACT前CTE所示2级受累进行预测的结果与理想手术方案的一致性均为中等（Kappa均=0.581，P均=0.021）。结论 术前CTE可用于预测对OC患者行肠切除以实现ODS的必要性。 |
| 英文摘要: |
| Objective To observe the value of preoperative CT enterography (CTE) for predicting the necessity of enterectomy in ovarian cancer (OC) patients for achieving optimal debulking surgery (ODS). Methods Preoperative CTE data of 49 patients with pathologically confirmed OC were retrospectively analyzed, including 13 cases received neoadjuvant chemotherapy (NACT) and 36 cases did not. The length (L) and circumference (C) of muscular involvement shown on CTE were taken as criteria for judging the necessity of enterectomy in OC patients ([degree 0:no muscular involvement, degree 1:L<3.0 cm and C<1/3, degree 2:L ≥ 3.0 cm [A] or C ≥ 1/3[B]). The patients were followed up for at least 1 year after surgery, and the actual operation results were recorded to estimate the ideal surgical strategy. The consistency of CTE evaluated necessity of enterectomy and the ideal surgical strategy was analyzed.Results For patients not undergoing NACT, according to degree 2 A or B showed on CTE, predicted results had excellent agreement with the ideal surgical strategy (Kappa=0.852, P<0.001), while those according to degree 1 or 2, 2 A, 2 B were all in good agreement with the ideal surgical strategy (Kappa=0.684-0.771, all P<0.001). For patients undergoing NACT, the predicted results of degree 2 muscular involvement showed on CTE before NACT had excellent consistencies with the ideal surgical strategy (all Kappa=0.806, all P=0.003). The predicted results of degree 2 muscular involvement showed on CTE after NACT had moderate consistencies with the ideal surgical strategy (all Kappa=0.581, all P=0.021). Conclusion Preoperative CTE could be used to predict the necessity of enterectomy in OC patients for achieving ODS. |
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