臨牀消化器内科 Vol.34 No.12(2-2)


特集名 遭遇の機会が増えたIPMN/膵囊胞―現状と課題
題名 IPMN/膵囊胞の診療 (2) IPMN/膵囊胞に対するUSの工夫と最大活用法
発刊年月 2019年 11月
著者 蘆田 玲子 大阪国際がんセンター検診部消化器検診科
【 要旨 】 IPMN国際診療ガイドラインをはじめ,膵囊胞性疾患に対する経過観察のモダリティとしては超音波内視鏡(EUS),MDCT,MRI/MRCPが多く推奨されており,腹部超音波検査(US)は含まれてはいない.しかし社会の高齢化が進む本邦においてUSは低侵襲かつ容易に施行できるもっとも普及しているモダリティであり,膵癌の早期発見においてなくてはならない検査である.一方,USには消化管ガスや肥満など被検者の体形による影響や術者の経験によるところが大きいというデメリットもある.そのため半座位や体位変換,飲水法などさまざまな工夫がその描出能改善のためには重要である.
Theme IPMN/Pancreatic Cyst as an Increasing Common Disease -- Current Status and Issues
Title Tips for Abdominal Ultrasound Use in IPMN and Pancreatic Cyst
Author Reiko Ashida Departments of Cancer Survey and Gastrointestinal Oncology, Osaka International Cancer Institute
[ Summary ] Endoscopic ultrasound (EUS), MDCT, MRI/MRCP are often recommended as follow‒up modalities for pancreatic cystic disease, including IPMN by international guidelines, although abdominal ultrasound (US) is not included in the recommendations. However, as the population ages in Japan, the use of US will be more important due to its low invasiveness and ease of use. US is the most widespread modality and an indispensable part of examination in early detection of pancreatic cancer. However, US has the disadvantage that it is largely influenced by the patient's body condition such as digestive tract gas or obesity as well as the experience of the operator. Therefore, various tips such as half sitting position, posture change, drinking water method, etc. are important in improving imaging quality of US.
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