|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|
|著者||永田 浩一||3D Imaging Laboratory, Department of Radiology, Massachusetts General Hospital and Harvard Medical School|
|【 要旨 】||要旨はありません。|
|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.