经直肠超声造影对肠腔狭窄型直肠癌的诊断价值

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关键词：经直肠超声造影；直肠癌；肠腔狭窄；T分期；肿瘤长度；肿瘤定位中图分类号：R445.1 文献标识码：A 文章编号：1000-503X（2025）05-0738-06DOI： 10.3881/j .issn.1000-503X.16556

ABSTRACT： ObjectiveTo evaluate the diagnostic value of transrectal contrast-enhanced ultrasound （CEUS） for rectal cancer with intestinal stenosis caused by tumors.MethodsForty-nine patients with rectal cancer underwent transrectal CEUS and magnetic resonance imaging（MRI） before surgery.Intraoperative tumor localization and postoperative pathological results were taken as the gold standard for diagnosis.The diferences in T stage， localization，and tumor length of rectal cancer were compared between the two methods.ResultsThe total accuracy rates of transrectal CEUS and MRI in diagnosing T stage were 75.5% （36/49）and 67.3% （33/49）， which had no significant difference （χ2=0.8 ， P=0.371 ）. The total accuracy rates of transrectal CEUS and MRI in judging tumor localization were 79.5% （39/49）and 77.5% （38/49），which had no significant difference （χ2=0.061，P=0.806） . The measurement results of tumor length in pathological examination had no significant difference from the transrectal CEUS results（ t=1.42，P=0.162） buta significant difference from the MRI results （ Δt=3.38 ， P=0.001 ）.Furthermore， transrectal CEUS detected 8（ 16.3% ）cases of colonic polyps among the 49 patients，while MRI did not detect colon lesions. ConclusionsTransrectal CEUS has good consistency with MRI in Tstaging and localization judgement of rectal cancer with intestinal stenosis，and this method can more accurately evaluate the tumorlength and simultaneouslyevaluate whetherthere isalesion inthe entire colon at the proximal end of stenosis.Itcan be usedas a supplementary examination before rectal cancer treatment in clinical practice.

Keywords：transrectalcontrast-enancedultrasound；rectalcancer；intestinalstenosis；Tstage；tumorlength；tumorlocali zation

我国结直肠癌发病率、死亡率在全部恶性肿瘤中分别居第3位、第5位，均呈现不断上升趋势，多数患者确诊时已是中晚期[1]，而晚期直肠癌局部复发风险高，常须采取新辅助化疗以增加根治性切除的机会[2-4]，故治疗前直肠癌的准确分期对患者治疗方案的选择和预后判断至关重要。（剩余8468字）