INTESTINE Vol.6 No.6(2-1)


特集名 新しい大腸内視鏡とその展望
題名 Virtual endoscopy (1) CT, MRI b. 下部消化管の3D-CT -- CT enemaとCT colonography
発刊年月 2002年 11月
著者 永田 浩一 昭和大学横浜市北部病院消化器センター
著者 遠藤 俊吾 昭和大学横浜市北部病院消化器センター
著者 大塚 和朗 昭和大学横浜市北部病院消化器センター
著者 為我井 芳郎 昭和大学横浜市北部病院消化器センター
著者 工藤 進英 昭和大学横浜市北部病院消化器センター
【 要旨 】 要旨はありません。
Theme Newly developed devices of colonoscope and their prospect in practice
Title Clinical application of three-dimensional CT for colorectal disease
Author Koichi Nagata Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Shungo Endo Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Kazuo Ohtsuka Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Yoshiro Tamegai Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Shin-ei Kudo Digestive Disease Center, Showa University Northern Yokohama Hospital
[ Summary ] Three-dimensional (3D) displays of large bowel using multidetector-row CT (MDCT) have recently become a popular clinical examination means with much improved images, owing to rapid progress in computer technology.
Since CT colonography is minimally invasive compared to colonoscopy, possibility of its clinical application for colorectal cancer screening was explored. Despite technical improvements, CT colonography is still inferior to colonoscopic examination for diagnosis of colorectal diseases, especially for flat lesions. CT colonography is not an ideal tool for colorectal cancer screening with present techniques.
CT enema demonstrates a good localization of colorectal cancer. Additionally, a grade of deformity becomes more prominent as a depth of invasion become deeper. CT enema appears to be a useful preoperative examination for laparoscopic and open surgery for colorectal cancer. Since 3D-CT is less invasive compared to barium enema, it should be the preferred method for preoperative examinations.
Progress in hardware and software for MDCT may further improve the quality of this imaging modality and its clinical applications may become broader in the near future.
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