CT colonographyの現状

CT Colonography

要旨　multidetector CT（MD-CT）を用いたCT colonography（CT-C）の現状について報告した．現時点でも，CT-Cはわが国ではColon fiber（CF）やX線検査と同等の診断能はない．特に隆起病変の病変の形態を見る場合にその診断能は低下する．しかし適応をうまく限れば補助検査としては有効な検査となりうる．本法の最適な利用法はCFやX線検査が施行困難な症例であろう．当科では盲腸まで挿入困難なTCFの支援検査，術後癒着や狭窄例，悪性腫瘍治療経過観察例などに施行している．しかしCT-Cは同時に得られるaxial，sagittal，coronal画像など管腔外の情報を得られる点では他のモダリティを凌駕しており一概には“不要”とは言えない．

　Owing to th development of computer technology, three-dimensional display of the gastrointestinal tract based on multi-detector CT has come to be commonly used. We have introduced here current use of CT-C in our group. Unfortunately CT-C is inferior to colon fiber (CF) and barium enema (BE) in the diagnosis of colonic diseases-especially in the form of polypoid lesions. CT-C should be used in cases when difficulties arise in CF or BE examination. At the moment suitable indications for the use of CT-C are as follows : support of TCF technical failure, difficulties of insertion to the oral side caused by cancer stenosis or inflammatory/carcinomatous adhesions on CF. We have concluded that CT-C is sometimes necessary because it has the advantage of supplying extraluminal information that cannot be obtained by other means.