小さな小腸病変に対するカプセル内視鏡，ダブルバルーン内視鏡，小腸X線の診断能の比較

Diagnostic Comparison of Small Lesions in the Small Bowel of Fluoroscopic Enteroclysis, Videocapsule Endoscopy, and Double Balloon Endoscopy

要旨　従来小腸の画像診断は小腸X線検査が主流であったが，カプセル内視鏡やバルーン内視鏡の開発により，小腸X線で描出困難であった小病変や平坦病変の検出が可能になった．そのような小病変は疾患別では血管性病変や医原性病変（薬剤性・放射線性小腸炎）が多かった．小病変の検査別有所見率の比較では小腸X線検査に比べ，有意にカプセル内視鏡，ダブルバルーン内視鏡の有所見率が高かったが，カプセル内視鏡単独，ダブルバルーン内視鏡単独では見落とし例もあるため，それぞれ補完して使用する必要がある．

　Videocapsule endoscopy and balloon enteroscopy are breakthrough methods for diagnosis of the small lesions in the small bowel, which are difficult to depict by fluoroscopic enteroclysis. In this study, we have compared the detection rates among fluoroscopic enteroclysis, videocapsule endoscopy, and double-balloon enteroscopy. Videocapsule endoscopy and double-balloon enteroscopy had significantly higher detection rates than fluoroscopic enteroclysis. In this study, VCE overlooked small bowel lesions in the Roux-en-Y jejunal loop and the proximal jejunum, while DBE failed to detect lesions deep in the middle portion of the small bowel due to inaccessibility, so complementary combination between DBE and VCE is recommended to diagnose small bowel diseases for the present.