INTESTINE Vol.12 No.2(2-1)


特集名 CT colonography
題名 CT colonographyによる大腸腫瘍性病変の診断 (1) CT colonographyと注腸造影・内視鏡検査との比較
発刊年月 2008年 03月
著者 永田 浩一 3D Imaging Laboratory, Department of Radiology, Massachusetts General Hospital and Harvard Medical School
著者 伊山 篤 サピアタワークリニック放射線部
著者 三上 鉄平 サピアタワークリニック放射線部
著者 花塚 文治 サピアタワークリニック放射線部
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 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 CT colonography
Title Role of CT colonography in preoperative colorectal cancer evaluation
Author Koichi Nagata 3D Imaging Laboratory, Department of Radiology, Massachusetts General Hospital and Harvard Medical School
Author Atsushi Iyama Radiology Section, Sapiatower Clinic
Author Teppei Mikami Radiology Section, Sapiatower Clinic
Author Bunji Hanatsuka Radiology Section, Sapiatower Clinic
Author Shungo Endo Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Shin-ei Kudo Digestive Disease Center, Showa University Northern Yokohama Hospital
[ Summary ] Computed tomographic colonography (3D-CT for colorectal cancer) is a new method for imaging the colon. In this article we provide practical advice concerning 3D-CT techniques for preoperative diagnosis. These techniques help ensure reproducible, high quality examinations.
Accurate preoperative assessment of colorectal cancer is essential in choosing the most appropriate therapeutic strategies especialy for patient prognosis. 3D-CT provide accurate evaluation of the bowel, cancer location, degree of cancer invasion outside the bowel wall and of extracolonic metastases. 3D-CT conbined with CT angiography is helpful in assessing vascular branching anatomy before colorectal cancer surgery. 3D-CT also has the potential to become an accepted technique for evaluation of nonvisualized parts of the colon after incomplete colonoscopy or conditions caused by stenosis. It can increase the diagnostic yield concerning masses and clinically important polyps in these parts of the colon.
By using polyethylene glycol solution plus contrast medium (PEG-C) bowel preparation, 3D-CT shows the entire colon without blind spots, clear differentiations between polyps and residual fluids are possible because the residual fluids are tagged with the water-soluble contrast medium. Use of 3D-CT after PEG-C preparation is not only feasible but safe. It can be used for preoperative evaluation of patients with colorectal cancer.
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