Preoperative evaluation of local invasion and metastatic lymph nodes of colorectal cancer and mesenteric vascular variations using multidetector-row computed tomography before laparoscopic surgery.
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.
Department of Radiology, Osaka Medical College, Osaka, Japan. kanaponnt@mail.goo.ne.jp
Takaaki
T
Kanamoto
Mitsuru
M
Matsuki
Junji
J
Okuda
Yuki
Y
Inada
Fuminari
F
Tatsugami
Masato
M
Tanikake
Shushi
S
Yoshikawa
Isamu
I
Narabayashi
Hiroshi
H
Kawasaki
Keitaro
K
Tanaka
Tetsuhisa
T
Yamamoto
Nobuhiko
N
Tanigawa
Yutaro
Y
Egashira
Yuro
Y
Shibayama
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D003082:Colectomy; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D010535:Laparoscopy; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging*; D008642:Mesenteric Veins / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011300:Preoperative Care; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media