胃と腸47巻10号

2012年09月発行

今月の主題 難治性Crohn病の特徴と治療戦略 主題

難治性腸管合併症の特徴と治療戦略―難治性瘻孔・狭窄の診断

著者： 竹内健¹ 小山繁彰² 飯田貴之³ 池谷賢太郎³ 佐藤慎祐² 日比智弘² 小泉雅廣² 中村元哉² 杉山高² 和田健² 阿部仁郎⁴ 渡邊文利³ 中村眞一⁵ 花井洋行³

所属機関： ¹東邦大学医療センター佐倉病院消化器内科 ²浜松南病院画像診断部 ³浜松南病院消化器病・IBDセンター ⁴浜松南病院外科 ⁵三菱化学メディエンス 病理・細胞診センター

ページ範囲：P.1504 - P.1513

要旨　Crohn病は慢性的な腸管壁全層におよぶ炎症を起こす疾患特性から，狭窄や瘻孔などの難治性合併症を高率に合併する．これらの危険因子として，病悩期間の他，病変範囲と局所の炎症の程度が関連することが指摘されている．CTやMRIは腸管と腸管外の画像情報を同時に提供し，病変範囲だけでなく，病変の炎症の状況も評価できる．特に，MDCT（multi detector-row CT）によるCTE（CT enterography）は，他の検査法と比較して，狭窄部の炎症の評価と瘻孔の描出をより可能にした．CTEの画像情報は，生物学的製剤の早期導入やバルーン内視鏡の適応などの治療戦略を検討する際に有用な情報を提供でき，X線造影検査やバルーン内視鏡検査とともにCrohn病の狭窄・瘻孔病変の診断に重要な検査方法である．

参考文献

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