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英文誌(2004-)

Journal of Medical Ultrasonics

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1990 - Vol.17

Vol.17 No.02

Original Article(原著)

(0160 - 0167)

原発性肝癌,転移性肝癌の超音波像の検討—日本超音波医学会の肝腫瘤の質的診断基準による—

Examination of the Usefullness of Ultrasonic Diagnostic Criteria for Hepatocellular Carcinoma (HCC) and Metastatic Liver Cancer (Meta)

宜保 行雄1, 古田 清1, 植村 一幸1, 今井 康晴1, 清沢 研道1, 古田 精市1, 横山 佳代子2, 草野 充郎3, 望月 哲仁4

Yukio GIBO1, Kiyoshi FURUTA1, Kazuyuki UEMURA1, Yasuharu IMAI1, Kendo KIYOSAWA1, Seiichi FURUTA1, Kayoko YOKOYAMA2, Mitsuo KUSANO3, Akihito MOCHIZUKI4

1信州大学第2内科, 2信州大学超音波室, 3長野胃腸病院, 4小諸厚生総合病院超音波室

12nd Dept. of Internal Medicine Shinshu University School of Medicine, 2Laboratory of US Shinshu University School of Medicine, 3Director of Nagano Icho Hospital, 4Laboratory of US Komoro Kosei General Hosoital

キーワード : Hepatocellular Carcinoma, Metastatic Liver Cancer, Diagnostic Ultrasonic Criteria

The ultrasonic criteria for diagnosing mass lesions in the liver was established by the Japanese Society of Ultrasonics in Medicine. We examined these criteria to test their usefullness in histological diagnosis of liver tumor by ultrasonography. Twohundred and sixteen cases of liver tumors (61 HCC, 86 metastatic liver cancer, 66 hemangioma, and 3 metastatic sarcoma) were examined in this study. Small tumors less than 2 cm in diameter were excluded. Hemangioma and metastatic liver cancers were used as controls. We studied the sensitivity, specificity and accuracy of each categories for HCC and metastatic liver cancers. Most reliable sonographic findings of HCC showed sharp and smooth boundaries, mosaic internal echo patterns, posterior echo enhancement, and lateral shadows. In contrast potato or cauliflower shapes, and the presence of a thick marginal hypoechoic zone with blurred internal sides were noticed in cases of metastatic liver cancer. From multivariate analysis, "boundaries" and "posterior echo" is the most useful items in the diagnosis between HCC and Meta. This diagnostic criteria for the pathology of mass lesions in the liver will be more useful to obtain an accurate histological diagnosis if appropriate weights were added to each categories. More exact explanations of the ultrasonic findings based on this criteria will be needed to reduce the rate of misdiagnosis.