CT enterography

CT enterography

要旨●小腸疾患診療におけるCTの位置付けは不明確であったが，CTと消化管X線造影検査との融合を目指して開発されたCT enterographyの登場により，小腸をCTで詳細に評価できるようになった．腫瘍性病変では粘膜下腫瘍の高い検出率，Crohn病では消化管合併症を含めた俯瞰的な評価が利点と考えられるが，サイズの小さな病変や粘膜面の微細な変化は評価できず，カプセル内視鏡と併用することにより診断能の向上が期待できる．一方で，CTはX線被曝を伴うため，低線量CTやAIを用いた画像補整による被曝低減の工夫に加えて，効果的な実施タイミングの検討が今後の課題である．

　The utility of CT（computed tomography）in the diagnosis of small intestinal diseases remains unclear. However, with the advent of CT enterography, which was specifically developed to integrate CT with small bowel radiography, the small intestine can currently be evaluated in detail. Therefore, this article is an overview of the usefulness of CT and CT enterography. The advantages of CT enterography include a high detection rate of submucosal tumors in neoplastic lesions and bird's-eye view of Crohn's disease and gastrointestinal complications. However, because small lesions and minor changes in mucosal surfaces cannot be evaluated, the use of CT in combination with capsule endoscopy is expected to increase. As CT involves X-ray exposure, future studies should employ methods to reduce exposure, such as low-dose CT and image correction via artificial intelligence and determine effective timing of their implementation.