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Journal of Medical Ultrasonics

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1988 - Vol.15

Vol.15 No.04

Original Article(原著)

(0325 - 0333)


Classification of Liver Cirrhosis Based on Hypoechoic Nodules of Parenchyma and Its Clinical Usefulness in Diagnosis of Cirrhotic Liver

木村 隆生1, 江原 正明1, 仁平 武1, 松谷 正一1, 木村 邦夫1, 税所 宏光1, 土屋 幸浩1, 小俣 政男1, 大藤 正雄1, 近藤 福雄2

Takao KIMURA1, Masaaki EBARA1, Takeshi NIHEI1, Shouichi MATSUTANI1, Kunio KIMURA1, Hiromitsu SAISHO1, Yukihiro TSUCHIYA1, Masao OMATA1, Masao OHTO1, Fukuo KONDO2

1千葉大学医学部第一内科, 2千葉大学医学部第二病理

1The First Department of Medicine, Chiba University School of Medicine, 2The Second Department of Pathology, Chiba University School of Medicine

キーワード : Parenchymal echo pattern, Hypoechoic nodules, Immersion experiment

We classified cirrhotic liver into four types on the basis of hypoechoic nodules sparsely or densely distributed in the parenchyma on echograms.
Type O: the parenchyma showing homogeneous echo texture.
Type I: the parenchyma showing heterogeneous echo texture, but no definite hypoechoic nodules.
Type II: the parenchyma showing hypoechoic nodules sized 3-5 mm.
Type III: the parenchyma showing hypoechoic nodules sized 5-10 mm.
According to the study by blind evaluation on the echo types of the parenchyma, normal liver showed type O, chronic hepatitis type O or type I, liver cirrhosis type O, type I, type II, or type III. Type II and type III were characteristically seen in liver cirrhosis.
Each echo type of liver cirrhosis was correlated with the size of nodules on laparoscopic findings. Type O and type I were highly correlated with micronodules, and also with mixed nodules on histological findings. Type II and type III were likewise with macronodules. Type I was seen in 23.1% of the patients with chronic active hepatitis, while it was none in those with chronic persistent hepatitis. It was evidenced by the comparative study between echo and histological findings on autopsied liver in the immersion experiment that hypoechoic nodules corresponded with regenerative nodules of cirrhotic liver.