Barrett食道癌のX線診断

X-ray Diagnosis of Barrett's Esophagus Cancer

要旨　Barrett食道および，そこに発生する腺癌についてX線撮影法，所見の読影について概説し，自験例のX線所見を病理所見と対比して検討した．食道胃接合部（EGJ）やsquamo-columnar junction（SCJ）が同定できれば腫瘍の発生母地の推定がX線でも可能であった．また，Barrett食道のX線像である顆粒状～網状の微細な粘膜模様もX線で描出でき，さらにその中の腫瘍を二重造影で良好に描出できれば，正面像の陰影斑の形，濃さ，または隆起成分の不整像，大きさ，立ち上がりなどから病変の成り立ちが推定でき，側面像による変形や伸展不良所見の有無から深達度の鑑別も可能と考えられた．しかし，平坦で側方に拡がる進展部の診断には困難性が示唆された．

　We present an overview of X-ray photography and interpretation of radiography findings of Barrett's esophagus and adenocarcinoma found in Barrett's esophagus. We also compared and examined the radiological findings of a case to its pathological findings. If the esophagogastric junction（EGJ）and squamocolumnar junction（SCJ）can be identified, the origin of the tumor can be estimated by X-ray examination. In addition, fine granular － reticular pattern on the mucosal membrane of Barrett's esophagus can also be visualized by X-ray examination. If the tumor in the area can be well visualized using double contrast radiography, the construction of the lesion can be estimated from the shape of the shadow spot on the frontal view, the color intensity, irregular image of prominence component, its size, and the degree of protrusion. Identification of invasion depth is possible based on deformation and presence or absence of ductile failure on lateral X-rays. However, the results suggested difficulty in diagnosing the progressing part that is flat and is spreading laterally.