胆囊における薄層造影法の有用性

Usefulness of the Thin Layer X-ray Contrast Method for the Gallbladder

要旨　1976年10月に胆囊薄層造影法を開発し，これを1988年10月までに164症例に応用した．病変は胆囊小隆起性病変20例（胆囊癌1例，結節状隆起2例，コレステロールポリープ17例），胆囊腺筋腫症4例，胆囊胆石症23例，総胆管結石症8例，総胆管拡張症11例，胆管癌2例などである．同造影法は1回の検査で連続して前壁像，後壁像を描出する．薄い薄層像，薄層像，薄層＋薄混合層像，薄層圧迫像，混合圧迫像から成り立ち，それぞれの性状を利用して，胆囊粘膜表面の凹凸を描出する．臨床例，基礎実験より胆囊薄層造影法による各種疾患の診断に言及し，薄層像ならびに薄層＋薄混合層像が胆囊小隆起性病変の診断に最も有用であることを報告した．

　I developed the thin layer x-ray contrast method for the gallbladder (TLG) in October 1976 after five years' study. TLG has been performed on 164 cases from October 1976 to October 1988. It is a technique that makes use of bile and contrast medium (60% urografin), and is composed of thinner-layer view, thin-layer view, thin-layer and thin-mixed-layer view, thin-layer view with press, and mixed-layer view with press. The mucosal surface of both the anterior wall and the posterior wall respectively is coated separately with contrast medium, and the picture is taken continuously with only one examination. The thin-layer view, and the thin-layer and thin-mixed-layer view are more useful in diagnosing small elevated cholecystic lesions as is illustrated by the case presented in this paper. TLG can be performed easily, safely, routinely and with out disconfort to the patient, so it is the most useful method for the diagnosis of early cancer of the gallbladder.