胃GISTのX線診断とその有用性

X-ray Examination and its Usefulness for Diagnosis of GIST of the Stomach

要旨　胃の広義のGIST(gastrointestinal stromal tumor)の5例を提示し，GIST診断における，X線検査法の有用性について述べた．GISTは主として固有筋層に主座を置く非上皮性腫瘍であり，粘膜面は潰瘍形成部を除き正常粘膜で覆われている．したがって，粘膜面の所見は癌との鑑別上必要であるが，主眼は壁内・外への発育形式を推測することにある．GISTのX線診断は，種々の体位の二重造影像，圧迫像を組み合わせ，病変を正面像，側面像として描出することにより，腫瘍の形態，表面性状，病変の固さ，管腔内・外への発育形式が推測でき，極めて有用と思われた．

　Five cases of GIST (gastrointestinal stromal tumor) (in a wide sense) of the stomach were presented, and the usefulness of X-ray examination for diagnosis of GIST was described. GIST is a non-epithelial neoplasm which lies mainly in the muscularis propria, while the mucosal surface is covered with normal mucosa except for the ulcerated part. Therefore, although the view of a mucosal surface side is necessary for differential diagnosis of cancer, the chief aim is to guess the form of intraluminar or extraluminar growth. With a combination of double contrast examination using various postures and compressive examination and a demonstration of the front and side image of the tumor, X-ray examination can make it possible to estimate the growth form, the surface condition, the hardness and the form of intra- or extraluminal growth of the tumor. For there reasons, X-ray examination is considered to be quite useful for the diagnosis of GIST.