Barrett食道癌の境界を読む―範囲と深達度：X線の立場から

Radiological Diagnosis of Barrett's Superficial Esophageal Cancer

要旨　症例を通じてBarrett食道表在癌のX線像について述べた．Barrett上皮の造影像は，比較的規則正しい微細な顆粒状陰影ないし網状陰影を呈した．微細顆粒状陰影は胃の粘膜模様よりさらに微細なものであった．表在癌の深達度診断は，正面像ではバリウム斑の大きさや濃さ，顆粒状陰影の大きさ，隆起成分の有無やその様相などの粘膜像をみる．側面像では不整像や伸展不良などの壁の変形に着目する．食道造影によるBarrett上皮および食道表在癌の診断は，食道の粘膜像を丹念に描出し，その粘膜像を読み取ることが大切である．そのためには，良好な二重造影像を撮影する必要がある．

　The esophagography of Barrett's superficial esophageal cancer was described through findings in actual cases. Fine granular shadow or reticular shadow are the findings accepted as those of Barrett's epithelium. The fine granular shadow was even more detailed than the gastric membranous pattern.

　In order to diagnose cancer, the size of barium spots, the depth of barium spots, the size of the granule-like shade, and the existence of an upheaval ingredient can be observed by the front-on image. To diagnose the depth of superficial cancer, the size and the shade of barium spots, the size of the granular shadow, and the existence of the elevated ingredient are also available in the front-on view. By the lateral view, attention can be focused on deformation of the esophageal wall.

　It is important for diagnoses by esophagography of both Barrett's epithelium and superficial esophageal cancer to obtain a membranous pattern, describe it carefully and to interpret it. Therefore, it is necessary to produce an esophagography, using the technique of double contrast imaging.

　1) Department of Diagnostic Radiology, Toranomon Hospital, Tokyo