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英文誌(2004-)

Journal of Medical Ultrasonics

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1988 - Vol.15

Vol.15 No.05

Original Article(原著)

(0404 - 0409)

超音波内視鏡におけるエコーレベル表示法−胃疾患への臨床応用

A Classification of Endoscopic Ultrasonic Echo Level in Gastric Diseases

梶山 徹1, 西尾 彰功1, 高鍬 博1, 兼松 雄象1, 松末 智2

Tohru KAJIYAMA1, Akiyoshi NISHIO1, Hiroshi TAKAKUWA1, Yuzo KANEMATSU1, Satoru MATSUSUE2

1天理よろづ相談所病院消化器内科, 2天理よろづ相談所病院腹部一般外科

1Department of Gastroenterology, Tenri Hospital, 2Department of Abdominal Surgery, Tenri Hospital

キーワード : Endoscopic ultrasonography, Echo level, Gastric disease

Endoscopic ultrasonography (EUS) enables us to clearly visualize the gastrointestinal tract and surrounding tissue. In ultrasonic study, although echo level plays an important role in qualitative estimation of the lesion, it is hard to appraise echo level objectively. For differential diagnosis of the gastric lesions detected by EUS (Olympus, GF-UM1 and GF-UM2), echo levels were classified into five grades which were based on the comparison with adjacent normal structures. According to this classification, level 0 corresponds to an anechoic pattern, level 1 to the 4th layer of the gastric wall, level 2 to the splenic parenchyma, level 4 to the 3rd layer of the gastric wall and level 3 between level 2 and 4. The optimal distance between the probe and the lesion for adequate evaluation of echo level was 30 to 40 mm. EUS was performed in 439 patients with gastric diseases such as carcinoma, ulcer, lymphoma, polyps and submucosal tumors. 249 histologically defined cases were analysed separately. The results as follows; internal echo of malignant lymphoma was relatively hypoechoic (mainly level 1), in contrast hyperplastic polyp showed relatively hyperechoic pattern (mainly level 3) and gastric cancer was depicted as intermediate echo level tumor between them. (p