バスタオルのり巻き法による前壁撮影の検討 第47巻1号43頁

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4 46 原著 バスタオルのり巻き法による前壁撮影の検討 Vol.47 1, Jan 図4 ①ポジショニングの判定基準 a 不適切 左側臥位 b 不適切 強度第二斜位 c 適切 正面位 軽度第二斜位 図5 ②示現範囲の判定基準 a 不適切 示現なし c 適切 ML領域が示現 図6 ③造影効果の判定基準 a 不適切 胃液による描出障害や造影ムラが著明 b 中間 適切 と 不適切 の中間 c 適切 胃液による描出障害や造影ムラがなく 濃淡差が良い b 中間 1 領域のみ示現 日本消化器がん検診学会雑誌

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8 50 図7 原著 バスタオルのり巻き法による前壁撮影の検討 Vol.47 1, Jan 症例 1 鈎状胃 同一被検者 a バスタオル未使用 ポジショニング 適切 示現範囲 中間 造影効果 中間 b 薄巻き状バスタオル使用 ポジショニング 適切 示現範囲 適切 造影効果 適切 としては 前壁二重造影が腹臥位で撮影されるこ 厚さや大きさなど形状調節がきわめて簡便なこと と 胃の偏位状態が分かりやすいこと 撮影順序 である さらに挿入後もバスタオル位置の微調整 にも影響しにくいことなどである また 表1で が実施しやすい また これまでのように前壁用 示したように牛角胃群では体格の良い男性被検者 フトンを数種類作製する手間がなく 比較的安価 が有意に多かった このような被検者の特徴を検 で入手しやすい バスタオルは素材が柔らかめで 査前に確認しておくと 胃形予測の点で参考とな あり 使用時に季肋部への痛みや肋骨骨折を生じ る る可能性も極めて少ない12 バスタオルのり巻き法の特徴は バスタオルの 前壁二重造影に対する画像精度評価の結果 鈎 日本消化器がん検診学会雑誌

9 Vol.47 1, Jan 図8 原著 バスタオルのり巻き法による前壁撮影の検討 51 症例 2 牛角胃 同一被検者 a バスタオル未使用 ポジショニング 不適切 示現範囲 不適切 造影効果 中間 b 厚巻き状バスタオル使用 ポジショニング 適切 示現範囲 適切 造影効果 適切 状胃群では②示現範囲 ③造影効果の点で 薄巻 したことで造影効果を高めたことなどが考えられ き状バスタオル使用時が有意に適切となった 薄 る したがって 鈎状胃であっても薄巻きバスタ 巻き状態で腹壁を軽度圧迫することによって胃が オルの使用が推奨される 一方 牛角胃群ではバ より平板状になり 接線部分を減少させる効果が スタオル未使用の場合 ①ポジショニング ②示 あったため示現範囲が拡大したものと思われた 現範囲 ③造影効果の3項目すべてが有意に不適 また 頭低位前に強度の右腰上げを行なわずに撮 切であったのに対し 厚巻き状バスタオルを使用 影可能となり 胃壁とバリウムの接触時間が増加 することによって 3項目すべて適切となった Journal of Gastroenterological Cancer Screening

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12 Study on the Effect of a rolled bath towel (Norimaki method) for complementing the double-contrast radiographic method applied to the gastric anterior wall Toshinobu MIZUMACHI 1), Keita NAKAHARA 2), Susumu MAEKAWA 3), Mitsuru SOEJIMA 1), Yu TAKAGI 4), Yumiko ARAKI 5), Osamu SERIKAWA 6), Yoshitaka TAMIYA, Yasutomo WATANABE, Ken KOMINATO, Osamu TSURUTA and Michio SATA 2) 1) Saga Prefectural Medical Association Health Evaluation Center, Saga, Japan 2) Division of Gastroenterology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan 3) Edagawa Clinic, Hyogo, Japan 4) Fukuoka Labor Hygiene Research Institute, Fukuoka, Japan 5) Fukuoka International Health Evaluation Center, Fukuoka, Japan 6) Serikawa Digestive organs Clinic, Kumamoto, Japan A new radiographic method for gastric cancer mass sur veys requires the use of a futon-mat for radiographing the gastric anterior wall so that the positioning of the stomach of an examinee can be optimized. However, specific effects of the futon-mat have rarely been reported. In our investigation, a bath towel was used instead of the futon-mat: so, we hereby report on the usefulness of the rolled bath towel, which was arbitrarily applied when radiographing the gastric anterior wall, and the shape of which was adjusted according to the shape of the stomach. A total of 83 stomachs (43 standard stomachs and 40 transverse stomachs), which were examined by the direct radiography for upper gastrointestinal portions, were employed for this study. The bath towel was adjusted like a Norimaki. A thin-rolled bath towel was used for the standard stomach, and a thick-rolled bath towel was used for the transverse stomach. Using the double contrast method for the gastric anterior wall of the standard and transverse stomachs, three matters (the positioning, picture range and contrast image on X-ray films) were comparatively studied between the two groups, with and without a bath towel compression. It was concluded that the last two matters were best attained for the standard stomach by the use of the rolled bath-towel, while all the three matters were best obtained for the transverse stomach by the use of the bath towel roll. Thus, the rolled bath towel method (i.e., Norimaki method) was found as an extremely useful technique to attain quality images, and the adjustment of the rolled bath towel to its best shape was so easy.

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