住野 泰清¹, 石井 耕司¹, 相川 勝則¹, 水吉 秀男¹, 菅野 茂男¹, 安部井 徹¹, 野中 博子², 佐々木 憲一³, 石井 誠⁴, 山崎 敏浩⁴, 山室 渡⁴, 上野 幸久⁴, 山寺 久⁵

Yasukiyo SUMINO¹, Kouji ISHII¹, Katsunori AIKAWA¹, Hideo MIZUYOSHI¹, Shigeo SUGANO¹, Tooru ABEI¹, Hiroko NONAKA², Kenichi SASAKI³, Makoto ISHII⁴, Toshihiro YAMAZAKI⁴, Wataru YAMAMURO⁴, Yukihisa UENO⁴, Hisashi YAMADERA⁵

¹東邦大学医学部第二内科, ²東邦大学医学部第一病理, ³東邦大学医学部第二病理, ⁴川崎中央病院内科, ⁵川崎中央病院超音波検査室

¹Department of Second Internal Medicine, School of Medicine, Toho University, ²Department of First Pathology, School of Medicine, Toho University, ³Department of Second Pathology, School of Medicine, Toho University, ⁴Department of Internal Medicine, Kawasaki Central Hospital, ⁵Ultrasonic Laboratory, Kawasaki Central Hospital

キーワード : Ultrasonography, Ultrasonic diagnosis of liver disease, Alcoholic liver disease, Ultrasonic-pathologic correlation, Ultrasonic-peritoneoscopic correlation

There are many cases with liver diseases, whose livers are swollen in a manner, in which the inferior surface of the liver is protruded convexly. Especially, in a case with advanced liver fibrosis, the liver is swollen and the caudal edge of the right lobe is turning over to a ventral direction, which we call "Mekure-agari" sign.
The marginal shapes of the right lobe of the liver on the echogram were studied in 100 cases with liver diseases (liver cirrhosis: 21 cases, chronic hepatitis: 34 cases, acute hepatitis: 11 cases, fatty liver: 14 cases, alcoholic liver fibrosis: 12 cases, others: 8 cases), and these shapes were also compared with peritoneoscopic findings and histopathological changes. The ultrasonic appearances were consistent with those of peritoneoscopic findings, and this "Mekure-agari" sign was relatively specific to alcoholic liver diseases, with marked fibrosis. The shapes seen by US could be divided in 4 classes, which were useful to predict histological features of the livers.