Đặc Điểm Hình Ảnh Cắt Lớp Vi Tính Của Tắc Đại Tràng Do Ung Thư Đại Tràng

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Tác giả: Quang Huy Huỳnh, Lê Cao Cường Phan

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.86

Bộ sưu tập: Metadata

ID: 339146

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- Mục tiêu: Mô tả các đặc điểm hình ảnh tắc đại tràng do ung thư đại tràng ở người lớn trên cắt lớp vi tính.- Đối tượng và phương pháp: 70 trường hợp tắc đại tràng cơ học được chụp cắt lớp vi tính và phẫu thuật tại bệnh viện Bình Dân tính từ năm 2019-2021. Trong đó, có 64 trường hợp tắc đại tràng do ung thư đại tràng, 6 trường hợp còn lại là do nguyên nhân lành tính. Tiến hành phân tích các đặc điểm hình ảnh tắc đại tràng và hình ảnh tổn thương tại vùng chuyển tiếp trong nhóm tắc do ung thư đại tràng, phân tích so sánh với nhóm tắc do nguyên nhân lành tính.- Kết quả: Trong nghiên cứu của chúng tôi, tất cả các trường hợp tắc đại tràng đều hiện diện hai dấu hiệu chính là đại tràng dãn nằm kế đại tràng xẹp và có vùng chuyển tiếp với tỉ lệ 100%, đường kính đại tràng thay đổi và phụ thuộc vào tình trạng dãn các quai ruột non kèm theo, trung bình là 6,7 ± 1,23 cm. Vị trí tắc thường gặp nhất là đại tràng Sigma. Đối với tắc đại tràng do nguyên nhân ung thư đại tràng, chúng tôi nhận thấy rằng hình ảnh tại vùng chuyển tiếp trên CT có các đặc điểm như sau: hình dạng thâm nhiễm lồi (93,8%), bắt thuốc cản quang mạnh thì động mạch (100%), kích thước theo chiều dọc (chiều dài) <
50mm (68,8%), thâm nhiễm mỡ xung quanh dạng nốt lưới (82,8%). Tất cả các tổn thương ung thư đại tràng trong nghiên cứu đều vượt quá giai đoạn T2.- Kết luận: Bên cạnh khả năng chẩn đoán chính xác bệnh cảnh tắc đại tràng, cắt lớp vi tính còn có giá trị cao trong chẩn đoán nguyên nhân tắc do ung thư đại tràng. Đây nên là phương tiện đầu tay trong thực hành lâm sàng đối với các trường hợp nghi ngờ tắc đại tràng.Abstract- Objectives: This study aims to evaluate radiological features on computed tomography of large bowel obstructions caused by colon cancer in adults.- Materials and Methods: Computed tomography examinations of 70 patients, who were affected by the colonic obstruction, have been operated on at Binh Dan hospital in three consecutive years between 2019 and 2021, including 64 cases caused by colon cancer and the remaining 6 cases which have benign causes. This study conducts and analyzes radiological features of bowel obstructions and images of lesions at the transition-point the in malignant large bowel obstruction group, as well as makes the comparison to that of the benign group.- Results: Our study figures out that all the reviewed subjects who were affected by bowel obstructions both present two primary signs: (100%) colonic distension proximal to the obstruction with collapse distally and the transition-point image, large bowel‘s diameter has altered, depending on the presence ofsmall bowel dilatation, with the mean of 6.7 ± 1.23cm. The dominant site of obstruction is the sigmoid colon. In terms of colonic obstruction caused by colon cancer, the computed tomography assessment has indicated these following features at the transition - point: convex appearance (93.8%), strong contrast enhancement in the arterial phase (100%), lesion length <
50mm (68.8%), reticulonodular fat stranding (82.8%). All the malignant lesions of the colonin the study were beyond stage T2.- Conclusions: In addition to providing high accuracy in diagnosing bowel obstruction, computed tomography also illustrates its potential in diagnosing the causes of colon cancer. Thus, this approach should be prioritized in clinical practice for suspected bowel obstruction patients. DOI: 10.59715/pntjmp.1.1.11

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