臨牀消化器内科 Vol.14 No.5(5-1)


特集名 超音波内視鏡の基本
題名 胃疾患に対する超音波検査の基本 (1) 超音波内視鏡による
発刊年月 1999年 05月
著者 芳野 純治 藤田保健衛生大学第二病院内科
【 要旨 】 胃の超音波診内視鏡検査(EUS)では主として脱気水充満法が用いられる.まず,胃液を十分に吸引した後,胃内の空気を吸引し,脱気水を注入する.脱気水を注入する位置は胃角部よりやや肛門側に内視鏡を挿入して行う.病変を正面視しているいる位置より口側に内視鏡をやや引き抜き,病変をわずかに遠目で見るような位置で描出すると良好な画像が得られる.位置関係の把握には肝臓・脾臓などの周囲の臓器や大湾のひだの位置を参考にし,一般に超音波像の右後壁,左が前壁,下が小湾,上が大湾である.EUSは胃癌の深達度診断,化学療法などの治療による経過観察,粘膜下腫瘍の診断,胃潰瘍の深さの診断や病態解析などに用いられている.
Theme Endoscopic Ultrasonography
Title A Basis of Endoscopic Ultrasonography for Gastric Lesions
Author Junji Yoshino Department of Internal Medicine, Second Hospital, Fujita Health University Scool of Medicine
[ Summary ] The de-aerated water filling methods is chiefly used in endoscopic ultrasonography (EUS) for the stomach. First, air in the stomach is removed after which the gastric juice is removed adequately and de-aerated water is filled in the stomach. De-aerated water is used to injected in the position where the endoscope is located, in a slight angle from the anal side. An excellent image is obtained when the endoscope is slightly pulled out from the position in which lesions are best observed. Tge location in the ultrasonographic images in confirned by the position of the surrounding oragas (liver, spleen, et al.) and folds in the greater curvature. In general, the right side in the image is the posterior wall, the left side is the anterior wall, the inferior side is the lesser curvature, and the superior side is the greater curvature. EUS is used for diagnostic assesstretment of gastric cancer invasion, obtain of the of tratment chemothrapy, diagnosis of submucosal tumors, diagnosis of the depth of stomachi ulcers, the physiological analysisi, etc.
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