上部消化管の炎症性疾患におけるX線検査の有用性

Usefulness of Radiographic Study in the Diagnosis of Inflammatory Disease in the Upper Alimentary Tract

要旨　上部消化管の炎症性疾患の診断においてもX線検査は内視鏡検査に比較して簡便で，侵襲が低く，小腸や大腸における炎症性腸疾患の診断と同様有用である．逆流性食道炎，食道潰瘍，食道裂孔ヘルニア，胃サルコイドーシス，アミロイドーシスなどでは概観撮影として臓器における病変の形態，配列の他，狭窄の程度等の診断が可能であり，X線検査の併用が有用な疾患は多く存在する．また，X線検査では粘膜，粘膜下層，固有筋層，漿膜下層，漿膜と層ごとの診断が可能なことから，急性胃粘膜病変などでも病態診断に有用である．さらに，粘膜面に異常を認めず，機能的異常を有するアカラシアやびまん性食道痙攣においては内視鏡検査に比較してその診断に有用であると考えられる．

　Radiographic study is as useful for the diagnosis of inflammatory disease in the upper alimentary tract as it is for the diagnosis of inflammatory bowel disease in the small bowel and the colon. Firstly, the safety and the easiness in carrying it out are the advantages of radiographic study. The shape, arrangement of the lesions, and the degree of deformity can be delineated as an overview study which is an advantage of radiographic study over endoscopy. Hence, it can be said that radiographic study is useful for diagnosis in the upper alimentary tract of inflammatory diseases such as gastro-esophageal reflux disease, esophageal ulcers, hiatal hernia, gastric sarcoidosis, and acute gastric mucosal lesions and other inflammatory diseases that may occur there. It is sometimes difficult to diagnose of functional disease without mucosal abnormalities such as achalasia or diffuse esophageal spasm, but the differential diagnosis of these diseases is also difficult for endoscopy. Radiographic study seems more useful than endoscopy for the diagnosis of functional disease such as achalasia, diffuse esophageal spasm and so on.