胃と腸55巻6号

2020年05月発行

今月の主題 スキルス胃癌—病態と診断・治療の最前線 主題

スキルス胃癌の進行度診断（CT，MRI，PET）

著者： 野津聡¹ 和田達矢¹ 山内辰雄²

所属機関： ¹埼玉県立がんセンター放射線診断科 ²埼玉県立がんセンター放射線技術部

ページ範囲：P.803 - P.819

要旨●スキルス胃癌の診断においてCT，MRIおよびPETは術前進行度診断，治療効果判定および予後予測に有効な画像診断である．造影CT多相撮影やMRI拡散強調像による胃壁の層構造の描出は，スキルス胃癌の診断に有用である．CTは最も汎用されている検査法であり，CTアンギオグラフィーは術前の血管解剖把握に役立つ．EOBを用いた造影MRIは肝転移の診断に特に有用である．また，MRI拡散強調像はCTで診断困難な骨破壊のない骨転移の診断にも有効である．PETはリンパ節転移や腹膜播種の感度が低く有効例は少ないが，遠隔転移の診断に役立つことがある．また，筆者らの研究では転移リンパ節のSUVmax 4以上の群は4未満の群より術後の平均無再発期間が短かった（p<0.05）．

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