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英文誌(2004-)

Journal of Medical Ultrasonics

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1990 - Vol.17

Vol.17 No.03

Original Article(原著)

(0260 - 0266)

超音波ドプラ断層法を用いた肝腫瘍鑑別診断法に関する研究

2-D Doppler Echographical Evaluation for the Differential Diagnosis of Liver Tumors

伊藤 洋二1, 川内 章裕1, 福成 信博1, 内藤 誠二1, 志賀 俊行1, 中山 国明1, 松井 渉1, 神谷 憲太郎1, 小池 正1, 石井 誠2, 米山 啓一郎2, 高橋 正一郎2, 小貫 誠2, 八田 善夫2

Yoji ITOH1, Akihiro KAWAUCHI1, Nobuhiro FUKUNARI1, Seiji NAITOH1, Toshiyuki SHIGA1, Kuniaki NAKAYAMA1, Wataru MATSUI1, Kentaro KAMIYA1, Tadashi KOIKE1, Makoto ISHII2, Keiichiro YONEYAMA2, Seiichiro TAKAHASHI2, Makoto ONUKI2, Yoshio HATTA2

1昭和大学医学部外科, 2昭和大学医学部第二内科

1Department of Surgery, Showa University School of Medicine, 2Department of 2nd Internal Medicine, Showa University School of Medicine

キーワード : 2-D Doppler echography, Liver tumor, Blood flow in tumor, Blood flow velocity

The clinical application of pulsed Doppler examination for the diagnosis of hepatocellular carcinoma (HCC) has been already reported, but it is not widely used because of the difficulty in detection of the blood flow.
In this study, using a 2-D Doppler echography equipment, SAL-65A (Toshiba Co., Tokyo) with 3.75 MHz and 5.0 MHz probe, the blood flow of the liver tumor was measured quantitatively and its clinical utility was evaluated.
Thirty nine patients with liver tumors including twenty one HCC, nine metastatic liver tumors and nine hemangiomas were examined to detect the blood flow in the tumor by the 2-D combined with pulsed Doppler method.
The 2-D Doppler detection rate of the blood flow in the tumor were 95% in HCCs, 56% in metastatic liver tumors and 44% in hemangiomas.
Doppler signals obtained from the tumors were classified into three types of Doppler spectrums; the high-velocity pulsative waveform (HV), the low-velocity pulsative waveform (LV) and the continuous waveform (CW).
Maximum blood flow velocity (Vmax) in the HV type was ranged from 0.4 to 1.08 m/sec, whereas Vmax in the LV type was ranged from 0.11 to 0.59 m/sec. All of Vmax in the CW type was less than 0.47 m/sec.
Doppler signals of the HV and CW types were detected mainly in boundary of tumor and Doppler signals of the LV types were detected in the center of tumor.
Vmax was ranged from 0.08 to 1.08 m/sec in twenty HCCs. In addition, Vmax equal to or more than 0.54 m/sec was obtained only in HCCs.
Five metastatic liver tumors out of nine, showed Vmax between 0.08 and 0.51 m/sec and all of nine hemangiomas revealed the low velocity blood flow less than 0.14 m/sec and the CW type of Doppler spectrums.
In conclusion, 2-D Doppler echography combination with Vmax measurement was useful to predict HCC.