電腦斷層攝影診斷未預料之結腸癌

UNEXPECTED COLON CANCER- DETECTED BY COMPUTED TOMOGRAPHIC EXAMINATION

刁翠美(Tiu Chui-Mei) ； 潘慧本(Pan Huay-Ben) ； 周宜宏(Chou Yi-Hong) ； 張遵(Chang Tsuen) ； 姜仁惠(Chiang Ien-Huey)

《中華放射線醫學雜誌》 12卷4期 (1987/12) Pp. 375-381

摘要

右側結腸癌的症狀出現較晚而常以腹部腫塊之形式求助於醫學影像學（medical Imaging）。CT應用於15名原發性結腸癌病例，在申請檢查之初，臨床並未特別懷疑結腸癌的可能性。CT發現此等腫瘤體積最小為4 × 4 × 3 cm。6名為息肉狀，9名為環狀結腸線癌，環狀較之息肉樣腸癌更具侵犯性。CT除可呈示原發性腫瘤之大小及內容外，對附近組織浸潤、肝臟、十二指腸、腎臟、輸尿管等之直接侵犯或遠端轉移等都能提供資訊。CT如發現腸癌之併發症如腸腔異常脹大或發生腸套疊時應考慮遠端結腸節段阻塞或近端息肉樣盲腸癌，自於鋇劑檢查仍可能有假陰性結果之發生，CT可作為腸癌檢查之輔助工具。

並列摘要

The clinical symptoms and signs of colon cancer arising from the ascending colon are usually late and mostly presented as abdominal mass when searching help from medical imaging. Fifteen patients, having primary colon cancer, were presented for computed tomography (CT) under variable clinical impressions apart from colon cancer. The smallest lesion detected was 4×4×3 cm^3, Six patients had polypoid tumor and nine patients had annular tumor which was more malignant than the former type. CT provides informations about the size and content of primary lesion, direct invasion or metastasis to the adjacent or distant organs, such as liver, duodenum, kidney and ureters. The detection of abnormal distension of colon or intussuception by CT indicate the possibility of complete obstruction by colon cancer or polypoid tumor causing intussuception. Barium enema and colonoscope remain the best modalities in diagnosing carcinoma of colon, but CT can be used as an adjunct, especially for the detection of the extent of the disease.