Crohn病の小腸・注腸X線所見

X-ray Findings for Diagnosis and Evaluation of Disease Activity in Crohn's Disease

Crohn病（CD）の診断および病変評価において，形態学的所見は極めて重要である．X線検査は内視鏡検査と比べると，局所所見，特に小病変の描出能は劣るが，全体像の把握や管外性の情報を知るには有用な検査法である．本稿では，CDの診断，治療方針決定および治療評価におけるX線検査の使用方法や注意点を中心に概説した．

　The morphologic findings are extremely important in diagnosis and in disease evaluation of CD（Crohn's disease）. At present, endoscopic modalities for the small intestine, such as VCE（video capsule endoscopy）or DBE（double balloon endoscopy）, have been developed and widely used for diagnosis of small bowel diseases. As for CD, DBE is very useful for evaluating small intestinal lesions, including typical lesions（longitudinal ulcer or cobble stone appearance）and small ulcerous lesions（erosion or aphthoid ulcer）. X-ray findings of the small intestine are inferior to DBE in the detection of small ulcerous lesions, however, they have a big advantage in evaluating precisely the entire small intestine even if small bowel stricture is present. These trends are also obtained among X-ray findings of the large intestine and total colonoscopy. In this manuscript, we describe the use of X-ray findings in the diagnosis, the morphologic evaluation for treatment decisions and the confirmation of the treatment effects.