38 全身の総合的画像診断 CT MRI US RI 血管造影 ᨺᑕ⥺⒪ 㻵㼚㼠㼑㼞㼢㼑㼚㼠㼕㼛㼚㼍㼘 㻾㼍㼐㼕㼛㼘㼛㼓㼥 㻔㻵㼂㻾㻕 ⏬ീୗ⒪ ᨺᑕ⥺⛉ᑓ㛛◊ಟ䝥䝻䜾䝷䝮 ᐇ⮫ᗋ䛻䛚䛡䜛ᨺᑕ⥺⛉䛾ᙺ䛿䚸ୗᅗ䛻♧䛩䜘䛖䛻䚸㼄⥺ᙳ䜔㻯㼀䚸☢Ẽඹ㬆⏬ീᰝ䠄㻹㻾㻵䠅䚸㉸㡢Ἴᰝ 䠄㼁㻿䠅䚸᰾་Ꮫᰝ䠄㻾㻵䠅䛚䜘䜃⾑⟶㐀ᙳ䛺䛹䜢⏝䛩䜛⏬ീデ䚸䛚䜘䜃⏬ീデ䜢ᛂ⏝䛧䛯⏬ീୗ⒪䠄䜲䞁䝍䞊䝧 䞁䝅䝵䝘䝹䝷䝆䜸䝻䝆䞊䠖㻵㼂㻾䠅䚸䛺䜙䜃䛻ᨺᑕ⥺䜢⏝䛧䛶✀䚻䛾ᝈ䜢⒪䛩䜛ᨺᑕ⥺⒪䛾㻟ᮏᰕ䛛䜙ᡂ䜚❧䛳䛶 䛔䜎䛩䚹 ㏆ᖺ䚸ᨺᑕ⥺デ⒪䜢ᢸ䛖་⒪ᶵჾ䛿┠ぬ䜎䛧䛔Ⓨᒎ䞉㐍Ṍ䜢㐙䛢䛶䛔䜎䛩䚹㻯㼀䛿㧗㏿䛛䛴ᗈ⠊ᅖ䛺ᙳ䛜⬟䛸䛺 䜚䚸㻝䟚௨ୗ䛾䛔䝇䝷䜲䝇䛻䜘䜚ヲ⣽䛺ゎ๗Ꮫⓗሗ䜢ᚓ䜛䛣䛸䛜䛷䛝䜎䛩䚹㻹㻾㻵䛿⤌⧊䝁䞁䝖䝷䝇䝖䛻ඃ䜜䛶䛚䜚䚸ゎ ๗Ꮫⓗ䛺䝬䜽䝻䛾ሗ䛾䜏䛺䜙䛪䚸⤌⧊䛾⾑ὶ䜔ỈศᏊ䛾ᣑᩓ䛺䛹䝭䜽䝻䛺ሗ䜎䛷ᚓ䜛䛣䛸䛜⬟䛷䛩䚹᰾་Ꮫ ᰝ䛷䛿䚸⮚ჾ䜔ᝈ䛾௦ㅰ䛻㛵䜟䜛ሗ䛜ᚓ䜙䜜䚸ᶵ⬟デ䛜⬟䛷䛩䚹㻵㼂㻾䛷䛿䚸⣽ᚄ䛾䜹䝔䞊䝔䝹䜢⏝䛔䛶䚸㐍 ⾜⫢⒴䛻ᑐ䛩䜛⫢⬦Ꮫሰᰦ⒪ἲ䜔እയᛶฟ⾑䛻ᑐ䛩䜛⥭ᛴ⬦ሰᰦ䛺䛹䜢⾜䛔䜎䛩䚹䜎䛯䚸⏬ീㄏᑟୗ䛷䛾 ⤌⧊⏕䚸యᙧᡂ⾡䚸⾑⟶ወᙧ䛾◳⒪ἲ䛺䛹䚸㻵㼂㻾䛾ᡭᢏ䜔㐺ᛂ䛿ከᒱ䛻䜟䛯䜚䜎䛩䚹ᨺᑕ⥺⒪䛷䛿䚸ᐃ 䛾㒊䜢䝢䞁䝫䜲䞁䝖䛷↷ᑕ䛩䜛యᖿ㒊ᐃᨺᑕ⥺⒪䚸⭘⒆䛾ᙧែ䛻㐺䛧䛯↷ᑕ⠊ᅖ䛚䜘䜃ᙉᗘ䜢ኚ䛥䛫䜛ᙉ ᗘኚㄪᨺᑕ⥺⒪䚸ᐦᑒ䞉㠀ᐦᑒ⥺※䜢⏝䛔䛯⤌⧊ෆ↷ᑕ⒪ἲ䛺䛹䚸᪂䛾ᢏ⾡䜢㥑䛧䛶䚸䜋䜌䛶䛾ᝏᛶ⭘⒆ 䛻㐺ᛂ䛜ᣑ䛧䛶䛔䜎䛩䚹䜎䛯䚸⏬ീሗ䛾ⴭቑ䛻క䛔䚸ㄞᙳ⎔ቃ䜒䝣䜱䝹䝮䛛䜙䝰䝙䝍䞊デ䜈䛸ኚ䛧䚸᪥㐍᭶Ṍ 䛷䛣䜜䜙䛾ᢏ⾡㠉᪂䜒㐍䜣䛷䛔䜎䛩䚹 ᨺᑕ⥺⛉་䛾ᙺ䛿䚸䛣䜜䜙䛾᪂ᢏ⾡䜢Ⰻ䛛䛴㐺䛺᪉ἲ䛷ά⏝䛧䚸䜘䜚⢭ᗘ䛾㧗䛔デ䞉⒪䜢ᝈ⪅䛥䜣䛻 ᥦ౪䛩䜛䛣䛸䛷䛩䚹⌧ᅾ䛾་⒪䛾⌧ሙ䛻䛚䛔䛶䚸㉁䛾㧗䛔⏬ീデ䞉ᨺᑕ⥺⒪䛿䚸㉁䛾㧗䛔་⒪䛻䛴䛺䛜䜛䛸䛔䛳 䛶䜒㐣ゝ䛷䛿䛺䛟䚸ᡃ䚻䛾ᙺ䛿┈䚻䛝䛟䛺䛳䛶䛔䜎䛩䚹デ⒪⛉䛾ᇉ᰿䜢㉺䛘䛶ከ䛟䛾ᝈ䛻ᦠ䜟䜛䛣䛸䛜䛷䛝䜛ᨺ ᑕ⥺⛉䛷䛾ᐇ⩦䛿䚸་⒪ᚑ⪅䛸䛧䛶䛾➨Ṍ䜢㋃䜏ฟ䛩◊ಟ་䛾ⓙ䛥䜣䛻䛸䛳䛶䚸ᴟ䜑䛶ᐇ䛧䛯䜒䛾䛻䛺䜛䛸☜ ಙ䛧䜎䛩䚹 䛬䜂䛸䜒䚸ᨺᑕ⥺⛉་䛸䛧䛶᪥䛾་⒪䜢ษ䜚㛤䛔䛶䛔䛝䜎䛧䜗䛖䟿 ಙᕞᏛ་Ꮫ㒊㝃ᒓ㝔䜢ᇶᖿタ䛸䛩䜛䛂ಙᕞᨺᑕ⥺⛉ᑓ㛛◊ಟ䝥䝻䜾䝷䝮䛃䛷䛿䚸㻯㼀䚸㻹㻾㻵䚸㻾㻵䛺䛹䛾⏬ീデ 䚸㻵㼂㻾䚸䛺䜙䜃䛻ᨺᑕ⥺⒪䛾㒊㛛䜢䚸㐢䛺䛟◊ಟ䛩䜛䛣䛸䛜⬟䛷䛩䚹་⒪䛾⣽ศ䛻క䛔≉ᐃศ㔝䛾▱㆑ 䛾䜏䜢⩦ᚓ䛧䛜䛱䛷䛩䛜䚸䛣䛾◊ಟ䝥䝻䜾䝷䝮䛷䛿䚸㡿ᇦ䜢⥙⨶䛩䜛䇾㻳㼑㼚㼑㼞㼍㼘 㻾㼍㼐㼕㼛㼘㼛㼓㼕㼟㼠䇿䜢┠ᣦ䛧䛶◊ಟ䜢⾜䛖䛣 䛸䛜䛷䛝䜎䛩䚹䛭䛧䛶䚸◊ಟ䜢✚䜏䛺䛜䜙⯆䛒䜛ศ㔝䛷◊✲ㄢ㢟䜢ぢ䛴䛡䚸䛥䜙䛻䛿䝃䝤䝇䝨䝅䝱䝸䝔䜱䛾㑅ᢥ䜔ᑓ 㛛་㈨᱁䛾ᚓ䜢┠ᣦ䛩䛣䛸䛻䛺䜚䜎䛩䚹 ᑓ㛛◊ಟ䛾㨩ຊ ᨺᑕ⥺⛉䛾≉Ⰽ
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全身の総合的画像診断CT MRI US RI血管造影
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IVR
a.
b.
c.
X 400CT 600MRI 300
120X 60
50IVR( ) 30
30
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IVR
MRI CT
US MRI IVR MRI CT
2
IVR
CT MRI CT
US IVR IVR MRI
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4
IVR
CT PET MRI CT MRI
US PET IVR CT
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MR spectroscopy MRSMRI (fMRI) MRS /
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