臨床外科71巻1号

2016年01月発行

特集 十二指腸乳頭部病変に対する新たな治療戦略—新規約・新ガイドラインに基づいて 診断

十二指腸乳頭部腫瘍に対する各種診断の進歩

著者： 枡かおり¹ 伊藤啓¹ 野田裕¹ 越田真介¹ 菅野良秀¹ 小川貴央¹ 柾木喜晴¹

所属機関： ¹仙台市医療センター仙台オープン病院消化器内科

ページ範囲：P.16 - P.20

【ポイント】
◆十二指腸乳頭部腫瘍（乳頭部腫瘍）では，内視鏡所見のみでの良悪性診断には限界があり，生検が必須である．
◆胆管・膵管開口部の深部の異型度が高いとされ，この部位からの生検を行う．近年，生検で診断困難な乳頭部腫瘍に対するEUS-FNAの有用性が報告されている．
◆現在，CTやMRIは，遠隔転移の有無や他疾患の除外診断を目的に実施されている．高分解能MRIや拡散強調画像（diffusion-weighted MR imaging：DWI）などが期待されている．

参考文献

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