小腸X線診断の微細診断能

Precise Roentgenographical Diagnostics of Fine Lesions in the Small Intestine

要旨　二重造影法の導入によって小腸の微細X線診断は飛躍的に向上した．小腸のX線診断には今は二重造影法が広く用いられている．この二重造影法による微細診断能を小腸Crohn病，小腸結核，アミロイドーシス，糞線虫症を対象に検討した．二重造影法には粗大，微細顆粒状陰影，大小フレック，網の目模様などが描写されていた．これらの微細診断の向上は臨床的にも大きな意義を持つものである．X線微細診断能をその描写能とX線像から肉眼所見への移し変えの2つに分けて検討した．描写能はこれまで幾つかの文献に述べられているように，まだ今後に残された問題がある．X線像から肉眼所見への移し変えはX線像に描写された直接症状だけでは難しい．ここには変形学が必要である．直接症状に変形学を加えることによって初めてX線微細診断は可能である．

　Introduction of double-contrast method has brought about rapid progress in roentgenographical diagnostics of fine lesions in the small intestine. The doublecontrast method is generally used nowadays to obtain roentgenographic diagnosis of small lesions in the small intestine.

　Precise roentgenographical diagnostics of fine lesions, based on the double-contrast method, was studied with reference to Crohn's disease, tuberculosis, amyloidosis and strongyloidiasis in the small intestine. The double-contrast pictures showed coarse and fine granules, flecks of various sizes and meshy patterns. The improvement in our ability to attain precise diagnostics of the fine lesions has a clinical significance.

　The precise roentgenographical diagnostics of fine lesions was further studied from the viewpoints of precise imaging of the lesions and reproduction of macroscopic pictures of the lesions based on roentgenograms. As has been described in other writings, some issues remain to be investigated further with regard to precise imaging of the lesions. On the other hand, the reproduction of macroscopic pictures of the lesions from roentgenograms alone is necessarily difficult and, accordingly, deformatology is another aspect which must be resorted to for this purpose. In other words attainment of precise roentgenographical diagnostics of fine lesions will not be possible till both roentgenographic pictures and deformatology are perfected.