胃全壁造影法ルチーン化の可能性について―特に被曝量の軽減化を中心に

Evaluation of X-ray Examination of the Anterior and Posterior Wall of Stomach for Routine Work

　経鼻的胃ゾンデによる胃内への造影剤の注入，空気量の調節，残留胃液の排出などの操作は，暗室透視などにおける精検用手技としてしばしば活用されている．しかし胃内に注入された大量の造影剤を遠隔操作のX線テレビを利用して，検者の被曝を全く考慮することなく，残留胃液とともに短時間に排出して，その後の検査を有利に展開しようということは，容易に誰にも考えられることであるが，現実にはまだ実用化されていない^1)～4)．

　筆者は，胃二重造影法⁵⁾の原理とこの造影剤迅速排出操作を組み合わせて，1枚のフィルムに，穹窿部から球部に至る胃全域の後壁あるいは前壁の二重造影像を，腸陰影に妨げられずに描出できないものかと多年にわたって考えつづけ，ようやく1昨年その成果を「図説・胃全壁造影法」⁶⁾（以下本法と略す）として発表した．

　By the development of Baricon Set (Barium Controller Set munufactured by Toshiba Medical Co.) and an easy-insertable nasogastric catheter (manufactured by Igakushoin Kikai Co.) X-ray examination of the anterior and posterior wall of the stomach has been simplified. Our chief aim was how to reduce patient exposure during fluoroscopy estimating surface exposure integral dose (SEI). We have tried to see whether this procedure can be made one of the routine works for upper GI examinations. For this purpose, 2455 cases were studied to know the actual duration of patient exposure during fluoroscopy together with its total duration, and to see if radiographic diagnosis can be made more accurate.

　Adoption of the newly developed apparatus and equipment has resulted in a certain reduction of SEI, shortened duration of fluoroscopic examination and improvement of radiographic diagnosis. We believe that initial steps have been taken in making this procedure one of the routine workups for upper GI examination. We have also illustrated here some examples of double contrast pictures revealing all parts on the anterior and posterior wall of the stomach using this method. A reference has also been made to the possible use of Baricon Set in barium enema examination.