胃粘膜下腫瘍のX線診断

Radiological Diagnosis of Gastric Submucosal Tumors

要旨●胃粘膜下腫瘍（SMT）におけるX線画像の意義はCT画像では描出困難な表面性状や立ち上がりなどの詳細な情報を付加できること，内視鏡では困難な腫瘤の全体像や位置関係を把握できる点にある．画像所見は腫瘤のoriginとなる層，大きさ，硬さ，発育方向などにより異なってくる．SMTの形態をとる病変は多岐にわたるが発生部位，多発の有無，立ち上がり，大きさ，頂部の陥凹などの表面性状，硬さなどに注目して読影していけばある程度まで鑑別を絞ることができる．SMT様の形態をとる上皮性腫瘍では腫瘍の構成要素のなかに上皮性腫瘍の所見を探すことがポイントである．

　The importance of radiological examination in the diagnosis of gastric SMTs（submucosal tumors）are highly-detailed observation of the mucosal surface pattern and rising shoulder, which are difficult to evaluate using computed tomography examination, along with recognition of the whole overview and positional relationships in the stomach, which is difficult to grasp via endoscopic study. Radiological findings differ depending on the layer of origin, size, the degree of hardness, and the direction of tumor growth. A variety of these lesions show an SMT-like appearance. Differential diagnosis of these lesions requires precise observation of the location, multiplicity, rising shoulder, size, depression, and the hardness of the tumor. Such findings from mucosal tumors are important in the diagnosis of SMT resembling mucosal tumors.