2007 Fiscal Year Final Research Report Summary
Establishment of prevention method of gastric perforation in endoscopic mucosal resection by high-resolution three-dimensional CT
| Project/Area Number |
18591354
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Radiation science
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| Research Institution | Kyushu University |
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Principal Investigator |
UTSUNOMIYA Takashi Kyushu University, Faculty of clinical radiology, Assistant Professor (00325854)
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| Co-Investigator(Kenkyū-buntansha) |
MATSUURA Shuji Kyushu University, Faculty of clinical radiology, Research Associate (40419594)
TSURUMARU Daisuke Kyushu University, Faculty of clinical radiology, Research Associate (90419565)
ISHIBASHI Tatsuyuki Kyushu University, Faculty of clinical radiology, Research Associate (00452748)
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| Project Period (FY) |
2006 – 2007
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| Keywords | endoscopic mucosal resection / gastric cancer / CT / 胃癌 |
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| Research Abstract |
We established the swine model of mucosal snaring involving the proper muscle layer of the stomach in endosoopic mucosal resection(EMR). We used contrast agent (Iopamidol, x20) as submucosal injection material to enhance the spread of injection material in the submucosal space. With use of contrast agent, we evaluated the multislice CT (64 detectors) findings of the gastric wall when the mucosa was adequately snared without involving the proper muscle layer in EMR. In our study, the ideal CT finding was defined as fellows; The snaring is performed within the lifiting area without involving non-lifting area Defect which indicates the involvement of proper muscle layer is not present in the submucosal contrast agent.In ideal snaring model, we visualized the wine glass-like appearance of submucosal contrast agent, hi feet, the wine glass appearance was recognized in ideal snaring model, but not in snaring model involving proper muscle layer. Although some cases without involving proper muscle layer, didn't demonstrate the wine glass-like appearance, this appearance was recognized in 86% of ideal model. The wine glass-appearance seemed to be the typical appearance of the adequate snaring in EMR. We, therefore, concluded that the wine glass-like appearance is a useful CT finding in EMR to prevent gastric perforation which can be caused by inadequate snaring: EMR is easier endosoopic treatment of early gastric cancer than endosoopic submucosal dissection (ESD). Establishment of prediction method for gastric perforation in EMR leads to the reevaluation of EMR and reduction of endoscopic operation time of early gastric cancer.
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