臨床婦人科産科61巻2号

2007年02月発行

今月の臨床 子宮体癌の最新知見─専門医のために

子宮体癌の画像診断

著者： 小宮山慎一¹ 宇田川康博¹

所属機関： ¹藤田保健衛生大学医学部産婦人科

ページ範囲：P.126 - P.131

文献概要

はじめに

　子宮体癌における画像診断の意義は大きく分けて2通りある．1つは術前に進行期を予測し，手術術式を決定するためであり，もう1つは治療効果の判定および治療後の再発や転移を検索するためである．本稿ではこの2つの観点から子宮体癌の画像診断に用いられる主な画像診断機器の特徴と診断に用いる際の留意点を概説し，併せて自験例の典型的画像を示しながら診断の実際について述べてみたい．

参考文献

1）関谷隆夫，丹羽邦明，山口陽子，他：超音波検査による子宮体癌診断法の要点．産婦人科の実際51 : 921-937, 2002

2）Karlsson B, Granberg S, Wikland M, et al : Transvaginal ultrasonography of the endometrium in women with postmenopausal bleeding─a Nordic multicenter study. Am J Obstet Gynecol 72 : 1488-1494, 1995

3）Turner LP : Role of transvaginal sonography in the evaluation of endometrial hyperplasia and cancer. Clin Obstet Gynecol 39 : 641-655, 1996

4）Emoto M, Tamura R, Shirota K, et al : Clinical usefulness of color Doppler ultrasound in patients with endometrial hyperplasia and carcinoma. Cancer 94 : 700-706, 2002

5）Alcazar JL, Galan MJ, Jurado M, et al : Intratumoral blood flow analysis in endometrial carcinoma : correlation with tumor characteristics and risk for recurrence. Gynecol Oncol 84 : 258-262, 2002

6）Sawicki V, Spiewankiewicz B, Stelmachow J, et al : Color Doppler assessment of blood flow in endometrial cancer. Eur J Gynaecol Oncol 26 : 279-284, 2005

7）Dessole S, Rubattu G, Farina M, et al : Risks and usefulness of sonohysterography in patients with endometrial carcinoma. Am J Obstet Gynecol 194 : 362-368, 2006

8）Manfredi R, Gui B, Maresca G, et al : Endometrial cancer : magnetic resonance imaging. Abdom Imaging 30 : 626-636, 2005

9）Barwick BD, Rockall AG, Barton DP, at al : Imaging of endometrial adenocarcinoma. Clin Radiol 61 : 545-545, 2006

10）Frei KA, Kinkel K, Bonel HM, et al : Prediction of deep myometrial invasion in patients with endometrial cancer : Clinical utility of contrast-enhanced MR imaging-A meta-analysis and Bayesian study. Radiology 216 : 444-449, 2000

11）Nagar H, Dobbs S, McClelland HR, et al : The diagnostic accuracy of magnetic resonance imaging in detecting cervical involvement in endometrial cancer. Gynecol Oncol 103 : 431-434, 2006

12）Rockall AG, Sohaib SA, Harisinghani MG, et al : Diagnostic performance of nanoparticle-enhanced magnetic resonance imaging in the diagnosis of lymph node metastases in patients with endometrial and cervical cancer. J Clin Oncol 23 : 2813-2821, 2005

13）Chao A, Chang TC, Ng KK, et al : 18F-FDG PET in the management of endometrial cancer. Eur J Nucl Med Mol Imaging 33 : 36-44, 2006

14）Yen TC, Lai CH : Positron emission tomography in gynecologic cancer. Semin Nucl Med 36 : 93-104, 2006

15）Khan N, Oriuchi N, Yoshizaki A, et al : Diagnostic accuracy of FDG PET imaging for the detection of recurrent or metastatic gynecologic cancer. Ann Nucl Med 19 : 137-145, 2005

16）Therasse P, Arbuck SG, Eisenhauer EA, et al : New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92 : 205-216, 2000

17）固形がんの治療効果判定のための新ガイドライン（RECISTガイドライン）-日本語訳JCOG版-http://www.jcog.jp/SHIRYOU/fra_ma/guidetop.htm