粘液産生膵疾患に対するバルーンERP圧迫撮影法の診断能―動態診断とその適応を含めて

Diagnostic Accuracy of Balloon ERP-Compression Study in Mucus-producing Pancreatic Lesion

要旨　粘液産生膵疾患(組織判明15例)に対する通常のERPとballoon ERP-CSの診断能を対比し，balloon ERP-CSが優れていることを示した．なかでも，本法の特徴である圧迫スポット撮影により，他の画像診断では診断不能であったintraductal adenocarcinomaの3例を診断することができた．ERP所見と病理組織診断を検討すると，分枝膵管拡張型9例では，hyperplasia8例，adenoma1例であった．一方，主膵管拡張優位型6例では，intraductal adenocarcinoma3例，adenoma1例，hyperplasia2例で癌が半数を占めた．囊胞の辺縁が平滑な分枝膵管のみの囊胞状拡張例は，balloon ERP-CSによる動態診断の適応と考えられた．

　We demonstrated the superiority of Balloon ERP-Compression Study (CS) over ordinary ERP in diagnosing mucus-producing pancreatic tumor (15 cases confirmed by histology). Compression spot radiography, in particular, revealed 3 cases of intraductal adenocarcinoma which were not detected by other imaging methods. Comparisons of ERP findings with pathological ones showed 8 cases of hyperplasia and a case of adenoma among 9 cases of dilated pancreatic duct branch type. On the other hand, 6 cases of dilated main pancreatic duct type included intraductal adenocarcinoma 3 cases, adenoma 1, and hyperplasia 2, half of these cases being cancer.

　Thus, diagnosis with Balloon ERP-CS was considered indicated in cases with cystic dilatation limited to the pancreatic duct branch with smooth border.