【摘要】 目的　探讨CT在直肠癌行腹会阴联合直肠切除术后局部复发的早期诊断及其与术后肉芽肿、纤维化的鉴别。资料与方法　选择 32例经随访、手术或穿刺证实直肠癌局部复发的CT表现进行分析 ,并与 15例术后正常改变作比较。结果　 32例局部复发病例表现 :骶前和 /或会阴部均见结节或肿块 ,除 3例外 ,2 5例骶前肿块呈不对称性分布 ,增强后大部肿块有明显均匀或不均匀强化 ,肿块累及邻近肌肉、器官有 2 3例 ,其他表现有骶骨侵犯、盆壁淋巴结肿大或有远处转移。 15例术后无复发病例CT表现 :12例见骶前斑片、索条状阴影 ,3例见软组织块影 ,左右对称或呈均匀分布 ,无会阴部肿块 ,无肌肉或邻近器官侵犯。结论　CT可以较早期检出直肠癌术后局部复发 ,以及与术后肉芽肿及纤维化的鉴别。更多还原

【Abstract】 Objective To evaluate CT scanning in detecting local recurrence of rectal cancer after Miles’ operation (abdomino perineal resection), and in differentiating recurrence with postoperative granuloma or fibrosis.Materials and Methods CT findings in 32 patients with clinically or pathologically proved local recurrent rectal cancer were retrospectively analyzed. Fifteen cases with normal postoperative fibrous tissue were used as control group. Results Presacral and/or perineal nodule or mass was seen in all 32 patients, of which the presacral mass was asymmetrically distributed on the left and right side in 25, homogeneous or inhomogeneous enhancement after contrast injection was seen in most cases. The neighboring muscle and organs were involved in 23 cases. The other findings included sacral destruction, pelvic lymph node enlargement and distant metastases. Of 15 cases in the control group, presacral patch or band shaped shadow was seen in 12, and symmetrically distributed presacral mass in 3. Neither invasion of the adjacent muscle or organ nor perineal mass was found in the control group. Conclusion CT scanning can early detect local recurrence of rectal cancer after Miles’ operation, and is helpful for the differentiation with postoperative granulation or fibrous tissue.更多还原