食道表在癌のX線学的深達度診断―X線造影像にみられる側面変形による深達度亜分類診断の試み

Radiological Diagnosis of Superficial Carcinomas of the Esophagus

要旨　食道表在癌134例を対象に，X線像側面変形による深達度診断の有用性について検討を行った．これまでの検討では，M3・SM1の鑑別診断にまだ問題を残しており，これをより精度の高いものにするために，今回は新たに病変および変形の大きさ（長さ）の要素を加えて，B2型，C型変形を呈した35症例に対して検討した．その結果，B2型変形は病変の大きさが30mm未満であればM3～SM1と言える．ただし30mm以上ではM2～SM2まで幅広く分布しており，鑑別は難しくなる．一方C型変形は，病変の大きさが20mm未満であればSM1かSM2で，10mm未満ならばSM2であった．また病変の大きさに関係なくC型変形の長さに着目してみると，変形の長さが20mm未満ならM3～SM2であるが，10mm未満ならSM1かSM2という結果であった．以上のように側面変形だけでもかなり精度の高い深達度診断が可能になったと考える．

　134 cases of Superficial Carcinomas of the Esophagus were examined concerning the possibility of radiological diagnosis for depth of invasion seen from the deformation of the lateral view. The element of the size of the lesions was added in the 35 cases in which the B2 type and C type deformation, which are characteristic of M3・SM1 were presented. These were also examined in detail by the examination data used to make the differential diagnosis of the M3・SM1. Though SM1 could be inferred from M3 if the size of the lesions were under 30mm, if it was over 30mm, it was difficult to discriminate SM1 from SM2 invasion in cases of B2 type deformation. On the other hand, in C type deformation, if the size of the lesions were under 20mm the invasion depth was either SM1 or SM2, and if the size of the lesions were under 10 mm, the invasion was SM2. We consider that precise diagnosis of depth of invasion is possible only in cases where the deformation of the lateral view is as mentioned above.