比較診断学からみたAGML―X線診断の検討

Analysis of X-ray Findings of AGML Based on Deformity Study: A Comparative Study of Radiologic Diagnosis between Inflammatory Colon Diseases and AGML

要旨　いまの診断域を越えたい，静止の一面をみる病理の学問を補足したい，あてがわれた診断学と診断域に住みついて永すぎる，観念的に，実験的に，理論的であることを狙いたい，ことなどから変形学を使いAGMLをみた．まず，虚血性大腸炎27例，薬剤性大腸炎29例につき，各層別にX線所見をとった．そして，粘膜には潰瘍，粘膜下には浮腫，thumbprints，筋層にはspasm，segmentation，longitudinal involvement，粘膜下と筋層の合併にはbamboo-joint signを対応させてみた．次に，上記所見をAGMLのX線写真上に求めた．これらの所見がAGMLにもみられることから，前記の考え方は，胃にも腸にもcommonに使えるX線所見だと考えられた．

　Firstly, from a radiological point of view, 27 cases of ischemic colitis and 29 cases of drug-associated colitis were examined to differentiate the layer involved in the disease process.

　We tentatively linked a specific x-ray finding to a specific layer as follows: ulceration to the mucosa; edema and thumbprints to the submucosa; spasm, segmentation and longitudinal involvement to the muscle layer; bamboo-joint sign to both submucosal and muscle layers.

　Based on this classification of x-ray findings we were able to precisely determine the layer responsible for the disease process.

　Secondly, we applied this classification to AGML. The foregoing associations of x-ray findings with layers involved were also confirmed for AGML. Thus, these x-ray findings seemed common for both the stomach and the colon.