The Diagnostic Value of Computer-assisted Post-processing Technique of CT Colonography for Patients with Colorectal Cancer

電腦輔助之後處理電腦斷層結腸影像在結腸直腸癌病人之診斷價值

游治維(Chih-Wei Yu) ； 顧逸康(Yi-Kang Ku) ； 李崇維(Chung-Wei Lee) ； 曾旭明(Yuk-Ming Tsang) ； 徐劍耀(Chien-Yao Hsu) ； 魏達成(Ta-Cheng Wei) ； 王德宏(Te-Hung Wang) ； 翁昭旼(Chao-Wen Weng)

《中華放射線醫學雜誌》 29卷2期 (2004/04) Pp. 53-60

摘要

本研究的目的在評估電腦輔助之後處理電腦斷層結腸影像在結腸直腸癌病人之診斷價值。總共34個由傳統內視鏡與／或結腸鋇劑檢查初步診斷為結腸直腸癌的病人，在他們進行手術前接受電腦斷層結腸影像檢查。由螺旋式電腦斷層儀取得影像後，將資料傳至一個獨立的電腦工作站做進一步分析。我們利用一個主觀量表來分析四種後置影像處理軟體用於病灶定位，評估漿膜外侵犯，尋找局部淋巴結腫，以及表現病灶表面的特徵的診斷價值。這四個軟體包括了Multi-planar reconstruction（MPR），Quick_colon ， CutPlane_colon，與Fly-through navigation。研究的結果顯示這四種後置影像處理軟體在不同的情形口有其診斷價值：MPR主要能將整段病灶的清楚地顯示出來，並且能利用顯影的型態與漿膜外侵犯的情況來協助診斷。Fly-through navigation則是在於表現病灶表面時特徵時顯得出色。Quick_colon則是利用與傳統結腸鋇劑檢查相似的表現方式來顯現病灶在三維空間的位置。CutPlane_colon能同時提供二維空間與三維空間的資訊。最後我們的研究結果顯示在這四種後置影像處理軟體中MPR在多項比較中得到最高的分數。因此，在這四種後置影像處理軟體中，MPR對病灶的定位以及病灶特徵的顯現具有最佳的能力。其他三種軟體則適合扮演輔助的角色。

關鍵字

結腸直腸癌 ； 電腦輔助之後處理 ； 電腦斷層結腸影像檢查 ； 虛擬結腸鏡

並列摘要

To evaluate the respective diagnostic value of computer-assisted post-processing applications in computed tomographic (CT) colonography for patients with colorectal cancer.
Thirty four patients with colorectal cancer diag-nosed by conventional colonoscopy and／or barium enema exanination underwent CT colonography prior to operation. These data were all acquired from a spiral CT scanner and were sent to a sepa-rate workstation for further evaluation. Four post-processing applications of volume rendering tech-niques including Multi-planar Reconstruction (MPR),Quick_colon, CutPlane_colon, and Fly-through Navigation were evaluated. The diagnostic performance of each application in localization, extraserosal invasion, regional lymph node involve-ment, and surface characterization was analyzed by a subjective grading score.
Each of the volume rendering techniques had respective value preoperatively in different ways: MPR application clearly demonstrated the whole extent of the lesion and it offered additional enhancement pattern and extraserosal information. Fly-through application offered an intraluminal visualization of the lesion simulating conventional colonoscopy. Surface unevenness, luminal constrict-tion, and the fungating nature of the lesion were shown clearly. A colonic fold which could mimic a projecting lesion in axial images could easily be excluded by this technique. Quick_colon application demonstrated the exact spatial location and extent of the lesion from the lesion from the whole segment of colon simu-lating conventional double contrast study, CutPlane_colon application slabed a 10 mm thick data into a composite image that offered both two-dimensional (2D) and three-dimensional (3D) infor-mation on asingle image. Finally, we found that MPR had the overall highest score in lesion detec-tion and demonstration among these post-processing applications. Among the post-processing applications in CT colonography, MPR is the best in lesion localization and demonstration. Other three applications serve a supplementary role in diagnosis.

並列關鍵字

Colorectal cancer ； Computer-assisted Post-processing ； CT colonography ； Virtual