Objective  To analyze the value of multiplanar reconstruction of multi-slice spiral CT (MSCT) in preoperative diagnosis and assessment of adjacent tissue invasion in colon cancer.

Methods  The clinical data of 100 patients with suspected colon cancer (62 males and 38 females, age (51.4±5.2) years) admitted to Tianjin Port Hospital from January 2022 to December 2024 were retrospectively analyzed. All patients underwent MSCT enhanced examination before surgery. The postoperative histopathological examination results were used as the "gold standard". The diagnostic efficacy of MSCT thin-layer reconstruction technique and MSCT thin-layer reconstruction+MSCT multiplanar reconstruction technique for colon cancer were compared. The assessment results of adjacent tissue invasion and the accuracy of TNM staging diagnosis of MSCT thin-layer reconstruction technique and MSCT thin-layer reconstruction+multiplanar reconstruction technique were compared. Statistical analysis was performed using SPSS 27.0 software. Measurement data conforming to normal distribution were expressed as ±s, and t-test was used for comparison between groups; count data were expressed as number (%), and χ² test was used for comparison between groups. P<0.05 was considered statistically significant.

Results  Among the 100 patients with suspected colon cancer, 93 were confirmed to have colon cancer by postoperative histopathological examination, and 7 patients were diagnosed with colon polyps (4 cases) and inflammatory bowel disease (3 cases) after laparoscopic colectomy. The sensitivity (and accuracy) of MSCT thin-layer reconstruction+multiplanar reconstruction technique for the diagnosis of colon cancer were higher than those of MSCT thin-layer reconstruction technique sensitivity: 98.92% (92/93) vs. 90.32% (84/93), accuracy: 99.00% (99/100) vs. 89.00% (89/100), χ²=6.764, 8.865, P=0.009, 0.003. There was no statistically significant difference in the specificity of MSCT thin-layer reconstruction+multiplanar reconstruction technique and MSCT thin-layer reconstruction technique for the diagnosis of colon cancer (100% (7/7) vs. 71.43% (5/7), χ²=2.333, P=0.127). Among the 93 patients confirmed to have colon cancer by postoperative histopathological examination, there were a total of 123 lesions (21 patients had multiple colon cancers), including 69 full-thickness lesions, accounting for 56.10%; 31 lesions in the muscularis propria, accounting for 25.20%; 16 lesions in the submucosa, accounting for 13.01%; and 7 lesions in the mucosa, accounting for 5.69%. The detection rate of adjacent tissue invasion (98.37% (121/123) vs. 82.93% (102/123), χ²=17.314, P < 0.001) and the accuracy of TNM staging diagnosis (96.77% (90/93) vs. 89.25% (83/93), χ²=4.052, P=0.044) of MSCT thin-layer reconstruction+multiplanar reconstruction technique were higher than those of MSCT thin-layer reconstruction technique.

Conclusion MSCT thin-layer reconstruction+multiplanar reconstruction technique has high diagnostic efficacy in preoperative diagnosis of colon cancer, can accurately assess adjacent tissue invasion and TNM staging of colon cancer, and provide guidance for the formulation of surgical plans for patients.