早期食道癌のX線学的深達度診断―m癌とsm癌の鑑別を中心に

Differential Diagnosis between m and sm Cancer of the Esophagus by Radiological Examination

要旨　①m癌とsm癌の鑑別に有用な指標は，隆起型病変では隆起の高さであり，陥凹型および平坦型病変では辺縁の陰影欠損あるいは二重輪郭，辺縁隆起の有無と共に病巣内の隆起の大きさが重要である．②ep癌とmm癌の鑑別は，正面像ではほとんど不可能で，辺縁像，特に伸展不良の強さの差が手掛かりとなる．③ep癌，mm癌の質的診断を確立するためには，まずそれらの病理組織学的診断基準を確立させておく必要がある．

　(1) Roentgen signs useful in differentiating m from sm cancer of the esophagus include the degree of elevation for an elevated lesion, and marginal filling defect, double delineation sign, marginal elevation as well as the size of the lesion for a depressed or flat lesion.

　(2) Differentiation between ep and mm cancer is almost impossible with en-face view. Profile view, however, gives a clue to differentiating these two con-ditions, especially when the esophageal wall is well distended.

　(3) Diagnostic criteria for ep cancer should be defined based on clinically confirmed evidences.