virtual endoscopyとCT enemaにより術前診断が可能であったS状結腸癌，多発大腸ポリープの1例

Virtual Endoscopy and CT Enema by Multidetector-row CT for a Patient with Obstructive Colon Cancer and Multiple Colon Polyps

要旨　大腸内視鏡が通過しない狭窄を来したS状結腸癌に対して，全大腸の描出をマルチスライスCTによるvirtual endoscopy像とCT enema像にて行い，術中大腸内視鏡所見と切除標本と対比した．マルチスライスCTによる三次元画像は前処置や解像度に問題が残るが，内視鏡が通過困難な症例の口側病変の描出が可能であり，そのCT enema像は注腸X線像にほぼ匹敵し，さらにはvirtual endoscopy像により腫瘍の全体像の把握が容易に行えるなど，今までにない画像が得られる．三次元画像は新しい情報であり，従来にない利用方法も考えられ，内視鏡検査や注腸造影検査に並ぶ検査法として確立される可能性が高い．

　We report the successful CT imaging of virtual endoscopy and CT enema in a patient with obstructive sigmoid colon cancer and multiple colon polyps, using multidetector-row CT. The three-dimensional (3D) images were compatible with intraoperative colonoscopic findings and the gross appearance of the resected specimen. It was also possible to make images of the proximal side of the obstructive colon cancer. Although bowel preparation and a spatial resolution can be a problem, the images visualized by 3D-CT are unique, and images of CT enema are similar to those of barium enema study. Additionally, virtual endoscopy can help us understand the whole image of a lesion. We think 3D-CT will become one of the new modalities for investigating colorectal cancer in addition to colonoscopy and barium enema study.