潰瘍性大腸炎のX線診断

X-ray Diagnosis of Ulcerative Colitis

　わが国の大腸X線検査は西沢・狩谷・吉川らの研究によって著しく進歩した．この検査法(以下，本法と略す)の進歩により，微細病変の診断が可能になった．fine network patternの描写と微小ニッシェの描写が可能になったために，大腸の潰瘍性病変の診断は大きく向上した．

　軽症の潰瘍性大腸炎も容易に発見され，従来の方法では難しかった本症の臨床経過も詳細に観察できるようになった．この方法によって描写されるX線像は，従来の教科書でみる本症のものとは随分かけはなれたものであり，彼らはこの微細X線像について著書“大腸のX線診断”に詳しく解説している．われわれも本法を用いて潰瘍性大腸炎の経過を丹念に追跡している．特に再発初期(増悪期)と軽症でinitial attackと思われるもののX線像をとらえるように努めている．

　X-ray examination of the colon has made remarkable progress in Japan thanks to research activities by Nishizawa Kariya, and Yoshikawa, et al., and presently it has become possible for us to detect even fine mucosal lesions. Taking up ulcerative colitis, for example, extents, degrees, stages and progresses of the disease at healing stage has been performed so far, although the disease at early relapsing stage has not been studied fully due to rare availability of such case. We have been trying to find out cases of colitis at early relapsing stage. In this study we demonstrate some cases, biopsy specimens of which showed the evidence of edema and hyperemia and/or slight infiltration in the rectum and sigmoid. X-ray findings of them are as follows. Bright granular pattern is a predominant finding. Granules vary in size and the outlines of them are not clearly defined. So-called “network pattern” is not seen. Small specks and/or spidery shadow are seen sometimes in addition to such findings. A contour is smooth and narrowing is not found. The X-ray findings of the lesions at early relapsing stage are as follows. The proximal limit of X-ray findings shows an abrupt transition from involved segment to non-involved one and bright large granules are seen at the proximal limit. We believe that at present ulcerative changes in colitis resulted from any disease can be detected by the use of this methods. The differential diagnosis between ulcerative colitis and those other diseases, therefore, has become necessary.