臓器別からみた形態診断学―胃・十二指腸疾患

Morphological Diagnosis by the Specific Organs, Gastro-duodenal Disorders

要旨　胃・十二指腸病変のうち早期胃癌と消化性潰瘍について形態診断の進歩を「胃と腸」を中心にしてまとめた．これらの疾患では1970年代にほぼ現在のX線・内視鏡診断学は完成されている．1980年代になると，新たに超音波内視鏡検査が加わった．最近ではCT，特にvirtual endoscopyを始めとする各種の三次元画像が登場してきたが，その診断能はまだ十分ではない．今後，科学技術の進歩により各種の検査法が更に進歩し，検査法を選択する幅は広がるであろう．しかし，社会経済環境などの変化により，低侵襲・低コストで，従来の診断能を維持できる検査法が選択されていくであろう．

　Progress in the morphological diagnosis of the gastro-duodenal diseases, especially focused on the early gastric cancer and peptic ulcer, was reviewed mainly by the articles of the “stomach and intestine”. The radiologic and endoscopic diagnosis of the upper gastrointestinal diseases was almost established in 1970's. In 1980's, endoscopic ultrasonography was added to the diagnostic modalities. The technique of three-dimensional imaging such as virtual endoscopic using computed tomography has been developed recently but diagnostic ability of the new technique is not enough for practice. In the future, progress in the technology would improve diagnostic modalities and widen the range of choice. But the changes of socio-economic environment would lead to choose less invasive and less expensive diagnostic modalities whose diagnostic abilities are the same as conventional ones.