Online Journal
IF値: 1.878(2021年)→1.8(2022年)


Journal of Medical Ultrasonics

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1991 - Vol.18

Vol.18 No.04

Original Article(原著)

(0327 - 0337)

血流動態解析による肝腫瘤の鑑別診断 −US angiographyの有用性について−

Differential Diagnosis of Hepatic Tumor: Usefulness of Ultrasound Angoigraphy with CO2 microbubbles

杤尾 人司1, 冨田 周介2, 工藤 正俊2, 平佐 昌弘2, 樫田 博史2, 岡部 純弘2, 三村 純2, 尾上 一美1, 簑輪 和士1, 浜田 充生1, 島田 啓子1, 森本 義人1, 伊吹 康良1, 小森 英司2, 織野 彬雄2, 藤堂 彰男2

Hitoshi TOCHIO1, Syusuke TOMITA2, Masatoshi KUDO2, Masahiro HIRASA2, Hiroshi KASHIDA2, Yoshihiro OKABE2, Jun MIMURA2, Kazumi ONOUE1, Kazushi MINOWA1, Michio HAMADA1, Keiko SHIMADA1, Yoshito MORIMOTO1, Yasuyoshi IBUKI1, Hideshi KOMORI2, Akio ORINO2, Akio TODO2

1神戸市立中央市民病院 腹部超音波室, 2神戸市立中央市民病院 消化器センター内科

1Section of Abdominal Ultrasound, Kobe City General Hospital, 2Division of Gastroenterology, Kobe City General Hospital

キーワード : Hepatic Tumor, US angiography, Arterial Vascularity

The ultrasound (US) imaging under hepatic arterial infusion of carbon dioxide microbubbles, a contrast agent for US, (US angiography) was performed on a total of 85 patients with a variety of 95 hepatic nodules; 62 hepatocellular carcinomas (HCC), 10 adenomatous hyperplasias (AH), 5 regenerative nodules (RN), 6 metastatic liver cancers (MLC), 2 focal nodular hyperplasias (FNH), and 9 hemangiomas. The diagnosis of all hepatic tumors except 9 hemangiomas were cofirmed histologically. The tumors were imaged from the very begining of the CO2 injection (early phase) up to the moment of complete washout from the liver (late phase). Out of the 62 HCCS, 53 (85%) were demonstrated to be hypervascular, 7 (11%) were isovascular, and 2 (3%) were hypovascular. In contrast, tumor stain was demonstrated in only 36 (58%) out of 62 HCCS with conventional angiography. US angiography also contributed to the differential diagnosis of the hepatic tumors by demonstrating specific vascular patterns of MLC, hemangioma, FNH, and AH. We concluded that US angiography is extremely useful in the differential diagnosis of hepatic tumors, and furthermore, that it is also useful in the determination of treatment option for HCC.