Wegener肉芽腫症における頭部CTスキャンの応用

An Application of Computed Tomography in Wegener's Granulomatosis

　I．はじめに

　Wegener肉芽腫症（以下WGと略す）は肉芽腫性病変と血管炎病変とをあわせもつ全身性疾患であり，上気道および下気道の壊死性肉芽腫性病変，全身の壊死性血管炎，巣状壊死性糸球体炎を組織学的特徴^1）とする。鼻および副鼻腔の症状は初発症状となることが多く^2），鼻腔・副鼻腔の肉芽腫性病変はWGの特徴的所見である。今回，頭部CTスキャンを使用し，WGの鼻腔内，副鼻腔内および眼窩内の肉芽腫性病変について検討したので報告する。

　Computed tomographic (CT) findings in four patients with Wegener's granulomatosis were investigated. The diagnosis of Wegener's granulomatosis was made by clinical symptoms and the histological examination of biopsied materials from the nasal mucosa, bronchus and kidney.

　CT findings in three patients were compatible with the clinical and laboratory manifestations of Wegener's granulomatosis. In one case, CT showed a widening of the nasal cavity, bone destruction of the ethmoid and maxillary sinus.

　These results suggest that CT studies are very effective to evaluate the extent of Wegener's gran-ulomatosis and its therapeutic effect.