表在型Barrett食道癌のX線診断

Radiological Diagnosis of Superficial Barrett's Esophageal Adenocarcinomas

要旨●表在型Barrett食道癌12例を対象に，X線造影検査による深達度診断および範囲診断について検討を行った．Barrett食道癌の診断には，食道胃接合部（EGJ）や扁平上皮円柱上皮接合部（SCJ）の同定が必要となるため，良質な二重造影での撮影が必須であり，背景にBarrett食道の存在を読み取ることが重要となる．病変の範囲診断に関しては，平坦に拡がる病変の側方進展および表層に凹凸変化の乏しい上皮下進展の診断は困難であったが，深達度診断に関しては側面変形を含めた従来の診断で十分に診断可能と思われた．

　Twelve cases of superficial Barrett's esophageal adenocarcinoma were examined by using X-rays to investigate the depth of invasion and by diagnosing the lateral extent. Accurate identification of the esophago-gastric junction and squamocolumnar junction is vital in the diagnosis of Barrett's esophageal adenocarcinoma. Consequently, high quality double-contrast radiography is required. It is also important to consider the existence of Barrett's esophagus in the background. Diagnosing the lateral extent was difficult when lesions were flatly spread or extended under the squamous epithelium without an irregular surface. However, diagnosis was possible using conventional diagnosis if supplemented by information regarding the deformation of the lateral view when we estimate the depth of invasion.