Angiography system combined with Toshiba BV-type X-TV Equipment. 2. Stereo-magnification system.

我々は，既設の消化管診断用X線TV装置（東芝BV型）を使用した立体拡大撮影システムを検討した。1．消化管診断用X線TV装置の透視天板の高さが一定であるため，従来のフィルムチェンジャー（AOT）では不可能であったが，上下動可能なフィルムチェンジャー（福放FC-10L特）を改良試作したことで最大2倍までの立体拡大撮影が可能となった。2．透視観察から撮影へ，コンタクト撮影から拡大連続撮影，立体撮影から立体拡大連続撮影へと併用して行うことが非常に簡単にできて被検者の負担軽減と多目的使用が可能となった。3．観察条件と立体感については，拡大率を変化させて，その立体感について検討した結果は、観察距離については，各拡大率における立体視しやすい距離は存在し，拡大率が2倍の場合には，観察距離を大きくするほど立体感も増加し，立体視し易い傾向が示された。Angiography of the head and abdominal region gives a good deal of peculiar information for the diagnosis of nature of pathological lesions. When angiography could be performed by stereo-magnification radiography, the radiography gives better information for physicians. In this article, we tried angiography by the stereomagnifying radiography system utilizing X-TV equipment for examination of digestive system. 1. To magnify film image, the film changer was modified to move up and down, because the board of TV table did not change vertically. The board of TV table was also modified to slide more widely. The modifications could make it possible to magnify the film image by two times. 2. To use the X-TV equipment brought some advantages as follows it became very easy for us to convert the X-TV system from fluoroscopy to radiography, and contact seriography was easily changed to stereo-magnification seriography

Angiography system combined with Toshiba BV type X-TV equipment. 1. Whole limb serial aort-arteriography

消化管診断用X線TV装置の天板機能を改良し，種々のフィルムチェンジャー，X線管球を組み合わせることにより，中規模病院において，スペース，経費などの点で有利な，血管造影システムを組むことができた。第1報では，このうち，下肢連続撮影システムについて紹介する。1．透視から造影まで，迅速に移行できるシステムとなった。2．スペース，経費の点で有利である。3．濃度補償については，LS-Ⅱ増感紙と，1.0cmエッジフィルターにより，体型によらず，全下肢にわたり，十分な補償効果が得られる。4．さらに長い長尺カセッテの開発が望まれる。A whole-limb serial aort-arteriography system constituted of BV-type X-TV and extralarge film changer was developed and used clinically. The results were as foll-ows. 1. By improving functions of the board of TV table, changes from fluoroscopy to radiography became easier in whole limb serial aort-arteriography. 2. By using LS-Ⅱ screen and 1.0cm edge filter, we could get well compensated X-ray photographs

Pelvimetry with smaller radiation field by CC･DR system- An examination on applying to lateral radiography of the pelvis (Guthmann) ―

100万画素CCDカメラを用いたI.I.-DR装置(CC･DRシステム)をX線骨盤計測に適用するため,被曝線量をはじめとするいくつかの点を検討した｡照射野内の被曝線量は従来の高感度Screen-Film システムであるG12/HRSと同等以下に抑えることが可能であった｡また,CC･DRシステムの9インチ円形照射野は一般的に用いられている大角フィルム面積の1/3であり,胎位の95%を占めるといわれている頭位の撮影においては胎児の生殖腺はもちろん, 赤色骨髄を多く含む脊椎への被曝を大幅に低減できた｡また,新たに開発された距離計測ソフトウェアーの正確度は良好で,通常lmm以下の誤差で測定が可能であることを確認した。その他,装置に標準装備されている自動露出機構の特性についても報告し,最後に撮影時の留意点についても検討した｡To apply CC･DR system (image intensifier digital radiography system including one million pixel CCD camera)to X-ray pelvimetry, We examined exposure dose of X-ray, radiation field, and accuracy of X-ray pelvimetry by the system. The hazards of radiation by CC･DR system were less than those of radiation by G12/HRS which is high sensitive screen-film system. 9 inch round radiation field by CC・DR system was one third of the area of 14×14 inch film. In cephalic presentation which occurs in about 95% of pregnancies, the damages of radiation by CC･DR system to fetal gonads and spinal bones including bone marrow much were less than those by usual X-ray examination. The accuracy of a distance measuring software devised newly for pelvimetry was reliable, and we could measure diameters with less than 1 mm deviations. Also we report the characteristics of automatic exposure controller annexed to this TV system and enumerate points to which we pay attention on taking a radiograph. Furthermore, It is expected that CC･DR system was useful to apply to superio-interior pelviography (Martius)

Clinical study on polypoid lesions of the colon

1986年4月から1990年2月末までの間に岡山大学医学部附属病院三朝分院で経験した早期大腸癌を含む大腸ポリープ90例（107病変）を対象に，年齢，臨床症状，便潜血反応，病変存在部位について検討を行い，以下の成績を得た。(1)大腸検査総数の22.4％にポリープが発見された。ポリープの77％は腺腫，5％は腺癌（早期癌）であった。(2)便潜血反応はポリープ例の75.9％に陽性であり，右側大腸ポリープでの陽性率は高かったが，S状結腸および直腸ポリープでは70％程度であった。(3)若年者では右側結腸にポリープが発見されることは稀であるが，50才以上では18％程度に認められた。高齢者では右側結腸も内視鏡で検査することが重要である。(4)免疫学的便潜血検査法の導入により大腸ポリープの発見効率が改善するものと考え られた。This report is concerned with clinical study on 90 patients with polypoid lesions (107 lesions) which we have encountered in Misasa Hospital, Okayama University in the past 4 years. Following results were obtained : (1) Polypoid lesions were detected in 90 (22.4%) and advanced adenocarcinoma (mostly resectable) in 22 (5.5%) of 402 patients who were examined by sigmoidoscopy and barium enema ; (2) Histological examination of the polypoid lesions showed adenoma in 77.2%, hyperplastic polyp in 8.7%, inflammatory polyp in 7.6%, neurinoma in 0.3% and early cancer (adenocarcinoma) in 5.4% ; (3) It was impossible to differentiate benign and malignant polypoid lesions on the basis of endoscopic and X-ray findings alone ; (4) Forty-two percent of the polypoid lesions was detected in the sigmoid colon, 30% in the rectum, 16.8% in the descending colon, 9.3% in the ascending colon, 0.9% in the caecum ; (4) Patients younger than 50 years of age showed only one polypoid lesion in the right hemicolon, whereas elder patients showed as many as 17 polypoid lesions ; (5) Among the 90 patients with polypoid lesions, 40 presented with abdominal pain, 20 with no symptoms (annual health check-up), 17 with irregular bowel habits, and 10 with melena ; (6) Among the 90 patients, occult blood in stool was positive in 75.8% with a lower positive rate in the lesions of the sigmoid and rectum ; (7) Among 5 asymptomatic patients with lesions and with a negative hemoccult test, 3 patients with a polypoid lesion were examined because of the patients' request, 1 patient with a polypoid lesion because of a positive family history, and the remaining 1 patient in a search for the primary lesion of the metastatic liver cancer ; (8) Among patients with a positive hemoccult test, the detection rate of polypoid lesions was 41.9% with use of an immunological method, whereas it was 19.7% with use of a chemical method. In conclusion, (1) detection of colonic polypoid lesions can lead to the detection of early cancer, although only histological examination can confirm the accurate diagnosis ; (2) a hemoccult test in stool with an immunological method is an effective method for screening asymptomatic colonic polypoid lesions, although it must be admitted that negative results may occasionally occur ; (3) macroscopic observation of the stool mass is important before sampling, because lesions of the sigmoid colon or the rectum may show scanty blood only on the limited area of the surface of the stool ; (4) patients elder than 50 years of age should be examined more carefully for the whole colon preferably with an endoscope, because they show a high incidence of small polypoid lesions in the right hemicolon

Relationship between bone mineral densities of second metacarpal bone and lumber spine

QCTおよびDIP法による測定値の相関性について検討し,DIP法による腰椎骨塩量の推定および,スクリーニングへの適用について考察した｡QCT値とΣGS/DやMClとの相関関係の検討では.対象のQCT値が低値か高値かによって相関関係がかなり異なることが明らかになった｡すなわち,QCT値が低い領域は,QCT値と,ΣGS/DやMCIに明らかな正の相関関係が認められたが,一方, QCT値が高い領域では,相関関係は認められなかった｡また,ΣGS/D=2.8mmAI以上,またはMCI=0.48以上の症例においては腰椎圧迫骨折の危険は小さく,ΣGS/D=1.8mmAI以下,またはMCI=0.24以下の症例においては腰椎圧迫骨折の危険が大きい可能性が示唆された。To compare bone mineral density between second metacarpal bone and lumber spine,　two measuring methods, digital image processing　method (DIP) for second metacarpal bone and quantitative computed tomography (QCT) for lumber spine were employed in this study. The bone mineral density was evaluated in 89 females and the results were compared between the two methods. A correlation between the bone mineral densities by QCT and ΣGS/D was found in subjects showing low mineral density by QCT, but not in those with high mineral density. These results reveal that DIP is useful to observe bone mineral density and if ΣGS/D and MCI are enough high, almost he hasn't risk of fracture of lumber spine

Relationship between vertebral transformation (or fracture) and bone mineral density in lumbar vertebrae.

QCTによる腰椎海綿骨骨塩量と,圧迫骨折を含む,椎体(第11胸椎～第4腰椎)の変形率の関係を検討した｡椎体変形率と腰椎QCT値の間の強い相関関係が確認され,椎体変形者全体の50%はQCT値70mg/cm(3)以下に分布し,90%は125mg/cm(3)以下に分布した｡さらに,この70mg/cm(3)付近での椎体変形者の割合は50%であり,125mg/cm(3)付近での椎体変形の割合は10%であった｡QCTによる腰椎海綿骨骨塩量測定値は,腰椎の変形および骨折の危険性を予 測する良好な指標であることが確認できた｡In 360 females, Bone mineral density (BMD) in lumbar vertebrae (L2-L4) was assessed by quantitative computed tomography (QCT), and the values obtained were compared with the frequency of vertebral transformation or fracture as assessed by lateral scan image (scanogram) by X-ray CT. A correlation was observed between the frequency of vertebral transformation (or fracture) and lumbar BMD values : BMD under 125mg/cm(3) was observed over 90% of women with vertebral transformation, and BMD under 70mg/cm(3) was found about 50% of them. These results suggest that decrease in BMD in lumbar vertebrae leads to vertebral transformation or fracture. Thus, measurement of BMD by QCT would be very useful in predicting vertebral transformation or fractures

気管支喘息におけるCTによる気腫性変化｡喫煙症例と非喫煙症例の比較｡

The percentage of attenuation area < -950HU (% LAA) on high resolution computed tomography (HRCT) was compared between 17 smoking and 24 nonsmoking patients with asthma. 1. FEV1/FVC value was lower in smoking patients (56.4%) than in nonsmoking patients (66.0%), however, the difference was not significant. 2. The percentage of LAA of the lung was larger in smoking patients compared with that in nonsmoking patients in all the three anatomic levels: the % LAA was 14.4% in nonsmoking and 20.3% in smoking patients at lower lung level (3cm above the top of the diaphragm). However, this was not significant. The maximal % LAA among the three lung levels on HRCT was 21.6±12.5% in smoking, and 15.7±11.9% in nonsmoking patients. This suggested that the maximal % LAA was larger in smoking patients, however, this was not significant. 3. The mean CT number of the lung on HRCT was smaller in smoking patients (-897.3HU) than in nonsmoking patients (-884.7HU). 4. Three of 4 nonsmoking patients whose % LAA was more than 30% had severe intractable asthma with long-term glucocorticoid therapy. The results suggest the possibility that smoking influences the % LAA of the lung on HRCT in asthma. It could be also speculated that % LAA is influenced by severity of asthma.HRCT (high resolution computed tomography)による-950HU以下の肺野のlow attenuation area(LAA)について,17例の喫煙喘息症例と24例の非喫煙喘息症例で比較検討した｡1.FEV1.0%値は,喫煙症例(56.4%)で非喫煙症例(66.0%)に比べ低い値が示されたが,両群間に有意の差は見られなかった｡2.% LAAは,肺野のいずれの高さにおいても,非喫煙症例に比べ喫煙症例で高い傾向が見られたが,有意の差ではなかった｡Maximal % LAAは,喫煙症例で21.6%,非喫煙症例15.7%であり,同様に喫煙症例で高い傾向が見られたが,有意の差は見られなかった｡3.平均CT値は,非喫煙症例(-884.7HU)に比べ,喫煙症例(-897.3HU)で低い値であった｡4.% LAAが30%以上を示 す4例の非喫煙症例のうち,3例がステロイド依存性の重症難治性喘息であった｡これらの結果より,喫煙が肺野の% LAAに影響をあたえる可能性もあるものの,疾患の重症度がより影響が強い可能性が示唆された