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肺結核は,肺機能の低下を伴いながらも治癒することが多い。近年,肺結核の診断には,胸部X線写真だけでなく胸部Computed Tomography(CT)がルーチンに使用されるようになっている。このため,CT画像より求めた肺容積と肺機能検査値との間に相関が認められれば, CTのみでも肺機能の把握ができるであろうと考えられる。本研究では,代償性気腫性変化を疑う肺結核20例に対して,ヘリカルCTより求めた肺容積と肺機能検査値との相関関係について検討した。その結果,正常肺容積と肺活量の間,および気腫性肺容積/全肺容積と1秒率の間に相関が認められた。従って,肺結核患者に対するヘリカルCTを用いた肺容積測定は,肺機能検査が出来ない排菌時の呼吸機能の把握やその予後の判断に充分貢献しうると考えられる。, Pulmonary tuberculosis cures much attended with respiratory depression. Recently, not only chest radiograph but also chest computed tomography(CT)are used for routine diagnosis of pulmonary tuberculosis. If the lung volume calculated using CT image is correlated with the value of respiratory function test, CT image will be enough to estimate respiratory function. In this study, correlations between the lung volume based on CT image and the values of respiratory function test were examined on 20 consumptive subjects suspected to have any compensating emphysema change. The results showed two high correlations;one was between normal lung volume(NLV)and slow vital capacity(VC)and the other was between emphysematous lung volume/total Iung volume(ELV/TLV)and forced expiratory volume in one second(FEVI). It is considered that the lung volume measurement using helical CT is very useful to estimate respiratory function of the patients who are avoided from respiratory function test because of infectivity.

近年,らせんCT装置が肺がん検診に用いられている。今回LSCT (Lung-cancer Screening CT) 装置の基本性能について検討した。LSCTのスキャン条件は120kV,50mA,テーブル移動速度20mm/s, X線ビーム幅10mmである。評価項目は雑音,高コントラスト分解能,低コントラスト分解能,空間分解能について行った。LSCTは一般のCTに比べ雑音,低コントラスト分解能は劣るが,高コントラスト分解能は良好である。被曝線量低減化と撮影時間の短縮により,肺がん検診には有用である。, Lately, helical volume CT has been used in lung-cancer screening (LSCT). In this report, we studied basic performance of LSCT. For the study of these, scanning parameter of LSCT were 120kV, 50mA, and the helical protocol of table incrementation of 20mm/s with 10mm collimation. The items of performance evaluation are noise, low contrast resolution, high contrast resolution, and spatial resolution.As a result, the noise and low contrast resolution of LSCT were deteriorated, however, the high contrast resolution shows equivalent performance incomparison with conventional helical CT. Therefore, the usefulness of the LSCT was confirmed with a reduction of exposure dose and examination time.

症例は5歳女児で2ヵ月ほど前, 頻尿と発熱を主訴に来院し, 膿尿を認めたことから尿路感染症の診断で抗生剤投与により解熱したが, 腹部超音波で右腎欠損, 膀胱右後方の嚢胞状構造物を指摘され, 精査目的で入院となった.造影CT・ヘリカルCT所見から交叉性腎変位を伴う尿管異所開口で, 右尿管は中腎管嚢胞を経由して腟に開口しているものと診断して手術を行った.開腹, 検索の結果では右腎は左腎下極に融合しており, 逆L字型の交叉性融合腎と判明した.融合部を切開して右腎および尿管を切除し, 尿管下端と中腎管嚢胞は剥離することで尿道狭窄や尿失禁をきたす可能性を考慮して放置した.術後2年経過の現在, 中腎管嚢胞は画像上判別困難な程度に縮小し, 感染等の合併症も生じていない, A 5-year-old girl with a rare anomaly of a single system ectopic ureter draining into the mesonephric duct cyst and ipsilateral crossed fused kidney is presented. Both ureters were catheterized and three dimensional (3-D) images of the urinary tract were reconstructed with helical computed tomographic (CT) data. A mesonephric duct cyst, the right ureter draining into the cyst and an ectopic orifice were well depicted with these images, especially with inferior projection images. 3-D display of helical CT data with a retrograde contrast study is a promising method of obtaining anatomical detail of an ectopic ureter.

Fast CT has changed conventional CT images, in which its fast scan time. Helical CT, added continuous table movement to fast CT, has also been advanced. In this article, we describe usefullness and problem of these fast CT.