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1.内蒙古医科大学附属医院影像诊断科,内蒙古 呼和浩特 010050
2.内蒙古医科大学第一临床医学院,内蒙古 呼和浩特 010059
Received:01 September 2025,
Revised:2025-11-16,
Published:28 April 2026
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王 晗, 郝粉娥. 多模态CT在结直肠癌淋巴结转移评估中的研究进展[J]. 肿瘤影像学, 2026, 35(2): 319-325.
WANG H, HAO F E.Citation: Advances in multimodal CT for assessing lymph node metastasis in colorectal cancer[J]. Oncoradiology, 2026, 35(2): 319-325.
王 晗, 郝粉娥. 多模态CT在结直肠癌淋巴结转移评估中的研究进展[J]. 肿瘤影像学, 2026, 35(2): 319-325. DOI: 10.19732/j.cnki.2096-6210.2026.02.012.
WANG H, HAO F E.Citation: Advances in multimodal CT for assessing lymph node metastasis in colorectal cancer[J]. Oncoradiology, 2026, 35(2): 319-325. DOI: 10.19732/j.cnki.2096-6210.2026.02.012.
结直肠癌(colorectal cancer,CRC)发病率近年来逐步升高。评估CRC患者淋巴结转移(lymph node metastasis,LNM)是疾病分期的关键,直接影响治疗选择和患者预后评估。随着医学影像学技术的发展,计算机体层成像(computed tomography,CT)作为临床常规检查手段,在LNM评估中至关重要。从传统形态学评估逐步向定量化、功能化及智能化方向演变。常规CT通过淋巴结短径、形态、边界及强化模式等特征评估转移,灵敏度和特异度受限。双能量CT(dual-energy CT,DECT)等功能成像技术的出现,为淋巴结内部成分变化、血供特征及微观结构异质性的无创评估提供了新思路。近些年研究已证实碘浓度(iodine concentration,IC)、标准化碘浓度(normalized iodine concentration,NIC)、有效原子序数(effective atomic number,
Z
eff
)和能谱曲线斜率等参数,可以有效地提高术前LNM的预测准确度。人工智能(artificial Intelligence,AI)的应用进一步丰富了诊断参数,推动淋巴结研究发展。新兴的AI技术在淋巴结自动检测、特征自动提取和精准预测方面表现出良好潜力。本文旨在综述CT技术及AI在CRC患者LNM评估中的优势与不足,为临床诊疗与后续研究提供参考指导,旨在实现更高效、精准的淋巴结评估和个体化治疗决策。
The incidence of colorectal cancer (CRC) has been gradually increasing in recent years. Assessing lymph node metastasis (LNM) in CRC patients is critical for disease staging
directly influencing treatment selection and prognosis evaluation. With advances in medical imaging technology
computed tomography (CT) has become a routine clinical examination method
playing a vital role in LNM assessment. The approach has evolved from traditional morphological assessment toward quantification
functional analysis
and intelligent evaluation. Conventional CT assesses metastasis based on features such as lymph node short axis diameter
morphology
margins
and enhancement patterns
but its sensitivity and specificity remain limited. The emergence of functional imaging techniques like dual-energy CT (DECT) offers new avenues for non-invasive evaluation of internal lymph node composition c
hanges
blood supply characteristics
and microstructural heterogeneity. Recent studies have confirmed that parameters such as iodine concentration (IC)
normalized iodine concentration (NIC)
effective atomic number (
Z
eff
)
and energy spectrum curve slope can significantly enhance the accuracy of preoperative LNM prediction. The application of artificial intelligence (AI) has further enriched diagnostic parameters and propelled lymph node research. Emerging AI technologies demonstrate promising potential in automated lymph node detection
feature extraction
and precise prediction. This review aimed to summarize the advantages and limitations of CT imaging techniques and AI in assessing LNM in CRC patients
providing reference guidance for clinical practice and future research to achieve more efficient
accurate lymph node evaluation and personalized treatment decisions.
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