注腸X線造影検査の位置付けと将来展望

Barium Enema Examination for the Diagnosis of Colorectal Neoplasms

要旨●大腸腫瘍の主な検査法として注腸X線造影検査，内視鏡検査，CTC（CT colonography）が挙げられる．しかし，内視鏡，CTCの機器の進歩と普及，X線検査医の不足により注腸X線造影検査数は減少傾向にある．そこで，注腸X線造影検査の大腸腫瘍診療における位置付けと将来展望について注腸X線造影画像を提示しながら考察した．注腸X線造影検査の絶対的適応は，内視鏡検査で深達度診断に迷う症例と内視鏡挿入困難例と考える．将来展望として，X線造影所見の解析にも人工知能を用いたコンピュータ診断支援システムが搭載され，施行医・読影医の負担が軽減されることが期待される．

　BE（barium enema）examination, colonoscopy, and computed tomography-colonography are the major procedures used for diagnosing colorectal neoplasms.

　Although its use has been declining in recent years, BE can still provide valuable information. BE should be performed for cases in which colonoscopy is not conclusive to diagnose the depth of invasion and when endoscope insertion is difficult. Computer-aided diagnosis systems, including artificial intelligence, are expected to be used for the diagnosis of colorectal neoplasms under BE examination in the near future.