Value of multiplanar reconstruction of MSCT in preoperative diagnosis and evaluation of adjacent tissue invasion in colon cancer

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

Methods  The clinical data of 100 patients with suspected colon cancer admitted to Tianjin Port Hospital from January 2022 to December 2024 were retrospectively analyzed, including 62 males and 38 females, with an age of (51.4±5.2) years. All patients underwent MSCT enhanced examination before surgery. With the results of postoperative histopathological examination as the "gold standard", the diagnostic efficacy of MSCT thin-slice reconstruction and MSCT thin-slice reconstruction+multiplanar reconstruction for colon cancer, and the evaluation results of adjacent tissue invasion and the accuracy of tumor, node, metastasis (TNM) staging diagnosis were compared. Chi-square test or Fisher exact probability method was used for comparison of count data between groups.

Results  Among the 100 patients with suspected colon cancer, 93 cases were confirmed as colon cancer by postoperative histopathological examination, and the other seven cases were confirmed as four cases of colonic polyps and three cases of inflammatory bowel disease. The sensitivity and accuracy of MSCT thin-slice reconstruction+multiplanar reconstruction in the diagnosis of colon cancer were higher than those of MSCT thin-slice reconstruction (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). No statistically significant difference was observed in the specificity of colon cancer diagnosis between MSCT thin-slice reconstruction+multiplanar reconstruction and MSCT thin-slice reconstruction (100% (7/7) vs. 71.43% (5/7), Fisher exact probability method, P=0.462). A total of 123 lesions were found in 93 patients confirmed as colon cancer by postoperative histopathological examination (21 patients had multiple colon cancers), including 69 full-layer lesions, accounting for 56.10%; 31 muscularis propria lesions, accounting for 25.20%; 16 submucosal lesions, accounting for 13.01%; and seven mucosal lesions, 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-slice reconstruction+multiplanar reconstruction for colon cancer were higher than those of MSCT thin-slice reconstruction.

Conclusions MSCT multiplanar reconstruction has high diagnostic efficacy in the preoperative diagnosis of colon cancer. It can accurately evaluate the adjacent tissue invasion and TNM staging of colon cancer and provide a reference for the formulation of surgical plans for patients.