Preoperative evaluation of local invasion and metastatic lymph nodes of colorectal cancer and mesenteric vascular variations using multidetector-row computed tomography before laparoscopic surgery

J Comput Assist Tomogr. 2007 Nov-Dec;31(6):831-9. doi: 10.1097/RCT.0b013e3180517af3.

Abstract

Objective: To evaluate local invasion and lymph nodes metastasis of colorectal cancer and mesenteric vascular variations using multidetector-row computed tomography (MDCT) before laparoscopic colorectal surgery.

Methods: Fifty-one patients with colorectal cancer underwent MDCT. The evaluation items were as follows: (1) local invasion; (2) detected lymph nodes evaluated by short-axis diameter, long-axis diameter, short/long axis diameter ratio, and computed tomography (CT) attenuation; and (3) visualization of mesenteric artery and vein by 3-dimensional-CT angiography.

Results: First, in the evaluation of local invasion, overall accuracy was 94.1%. Second, the point of 0.8 or greater in short/long-axis diameter ratio was best index for the diagnosis of metastatic lymph nodes. Using this index, the accuracy of the diagnosis per node was 80.5%. Third, 3-dimensional-CT angiography correctly demonstrated variations of the mesenteric artery and vein.

Conclusions: The MDCT was effective for evaluation of local invasion and lymph nodes metastasis of colorectal cancer and mesenteric vascular variations before laparoscopic surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography / methods
  • Colectomy
  • Colonic Neoplasms / diagnostic imaging*
  • Contrast Media
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Imaging, Three-Dimensional / methods
  • Laparoscopy*
  • Lymph Nodes / diagnostic imaging
  • Lymphatic Metastasis / diagnostic imaging*
  • Male
  • Mesenteric Arteries / diagnostic imaging*
  • Mesenteric Veins / diagnostic imaging*
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Preoperative Care
  • Rectal Neoplasms / diagnostic imaging*
  • Retrospective Studies
  • Single-Blind Method
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media