臨牀消化器内科 Vol.27 No.8(1-1)


特集名 下部消化管粘膜下腫瘍の診断と治療
題名 総論 (1) 注腸X線検査
発刊年月 2012年 07月
著者 青見 賢明 福岡大学筑紫病院消化器内科
著者 久部 高司 福岡大学筑紫病院消化器内科
著者 松井 敏幸 福岡大学筑紫病院消化器内科
【 要旨 】 注腸X線検査は,腸管の走行や病変の位置が把握でき,3次元的な構造が理解しやすい.下部消化管の粘膜下腫瘍(submucosal tumor;SMT)のX線所見の特徴は,表面が正常粘膜に被覆され,立ち上がりなだらかな隆起性病変である.病変周囲から病変の上に乗り上げていくbridging foldを伴う.頂部に認める中心陥凹の有無も良悪性の鑑別に役立つ.X線診断では,病変の大きさ,発生部位,硬さの程度,X線透過性等を加味して鑑別診断を行うことが重要である.鑑別診断は上皮性の癌や転移性腫瘍,子宮内膜症や大腸囊胞気腫症等がある.
Theme Diagnosis and Treatment of Lower Gastrointestinal Tract Submucosal Tumors
Title Radiological Diagnosis of Lower Digestive Tract Submucosal Tumors
Author Yoshiaki Aomi Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Takashi Hisabe Department of Gastroenterology, Fukuoka University Chikushi Hospital
Author Toshiyuki Matsui Department of Gastroenterology, Fukuoka University Chikushi Hospital
[ Summary ] Barium enemas enable us to identify the course of the gastrointestinal tract and locations of lesions, and facilitate the elucidation of three-dimensional structures. Submucosal tumors of the lower digestive tract typically appear on X-ray images as elevated lesions with a gentle slope and a surface covered with normal mucosa. Such lesions are associated with bridging folds that extend over the lesion from the surrounding area. The existence of a central depression in the tumors contributes to a differentiation between benign and malignant tumors. Differential X-ray diagnosis based on factors such as the size, location, rigidity, and radiolucency of the lesion is important.Submucosal tumors should be differentiated from carcinomas, metastatic tumors, endometriosis, or pneumatosis cystoides intestinalis.
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