X線的胃小区像からみた背景粘膜の質的診断

Diagnosis of Histological Location of Gastric Mucosa by Radiological Findings of Gastric Area

要旨　幽門腺粘膜領域55例（噴門腺粘膜領域1例を含む），中間帯領域27例，胃底腺粘膜領域22例の比較的小さな早期癌計104例を対象に，病巣周囲粘膜領域を任意に選択し，X線二重造影による胃小区像からみた背景粘膜の質的診断について検討した．①顆粒の大きさ，粘膜萎縮あるいは腸上皮化生の程度，顆粒間の開大，顆粒の大きさと形の均一性の所見から総合的に判定することによって可能である．②これらの所見に，解剖学的な部位，性別や年齢などによる腺境界の移動を加味することによって，診断はより正確になる．③X線的に描出された比較的大きな胃小区像の表面には，更に微細に分画された顆粒状陰影や微小な点状陰影が認められ，粘膜萎縮の変化によって大顆粒から小顆粒への分画が生じることが推察された．

　To evaluate diagnosis of histological location of gastric mucosa by the double contrast radiological findings of gastric area, surrounding mucosal areas from 104 cases of relatively small gastric cancer (55 cases of pyloric gland mucosal area including one case of cardial gland mucosal area, 27 cases of intermediate area, and 22 cases of fundic gland mucosal area) were randomly selected. Histological diagnosis of surrounding area could be suggested by the following radiological findings size of granules, degree of mucosal atrophy and intestinal metaplasia, distance between granules, uniformity of size and shape of granules. Consideration of anatomical location and movement of border between pyloric and fundic gland by aging and sexual difference would contribute more precise diagnosis. There found fine granular shadows and minute punctate shadows on the surface of the relatively large gastric area which was detected by the radiologic examination, and this finding suggested that mucosal atrophic change might transform large granules to small granular components.