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Journal of Medical Ultrasonics

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1989 - Vol.16

Vol.16 No.05

Original Article(原著)

(0453 - 0462)


Sonographic Evaluation of Abdominal Splanchnic Systems in Dialized Patients, Mainly Dealing with Kidney, Spleen, Gall Bladder and Ascites.

原沢 博文1, 山崎 親雄2, 伊藤 晃2, 高木 千尋3, 古田 哲也3, 佐々 ひとみ3

Hirofumi HARASAWA1, Chikao YAMAZAKI2, Akira ITOH2, Chihiro TAKAGI3, Tetsuya FURUTA3, Hitomi SASA3

1増子病院放射線科, 2増子病院内科, 3増子病院放射線科エコ一室

1Department of Radiology, Masuko Institute for Medical Research, 2Department of Internal Medicine, Masuko Institute for Medical Research, 3Laboratory of Ultrasound, Department of Radiology, Masuko Institute for Medical Research

キーワード : US, Hemodialysis, ACDK, Splenomegaly, Ascites

In the period 1987-88, sonograms of 93 patients undergoing hemodialysis (HD) were obtained to evaluate renal features, splenomegaly, gall bladder disease, ascites, and liver and pancreas disease.
Renal echogenicity increased gradually with HD duration. While a gradual decrease of the magnitude of diabetic nephropathy (DMN) was correlated with HD duration, the magnitude of chronic glomerulonephritis (CGN) was not. A high tendency for renal cyst formation after the third year of HD is well-known, and a statisticallysignificant difference (pMalignant tumors werefound in 4 patients. They included a hepatoma and 3 renal cell carcinomas, one with ACDKand 2 without. One of the renal cell carcinomas showed liver metastasis 3 months after surgery. This suggested that renal cell carcinomas in HD patients were not uncommon, and inferred that strict sonographic monitoring of HD patients would be needed to detectmalignancies early.
Of 93 patients, 14 (15.1%) had gall bladder calculi. This was high, compared with a large-scale examination conducted during the same time period in our hospital. Eleven patients without liver disease had mild ascites, and 21 hadsplenomegalywhose straight regression was positively correlated with HD duration and negativelycorrelated with platelet number.