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英文誌(2004-)

Journal of Medical Ultrasonics

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1992 - Vol.19

Vol.19 No.04

Original Article(原著)

(0277 - 0287)

カラードプラ法による肝腫瘤の鑑別診断−血流シグナルの流速波形解析を用いて−

Differential Diagnosis of Hepatic Tumors Using Color Doppler Flow Imaging: Value of the Doppler Spectral Analysis.

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

Hitoshi TOCHIO1, Kazushi MINOWA1, Syusuke TOMITA2, Masatoshi KUDO2, Keiko SHIMADA1, Michio HAMADA1, Hiroshi KASHIDA2, Yoshihiro OKABE2, Jun MIMURA2, Kazumi HAMADA1, Masahiro HIRASA2, Yasuyoshi IBUKI2, Hideshi KOMORI2, Akio ORINO2, Yoshito MORIMOTO1, Akio Todo2

1神戸市立中央市民病院臨床病理科腹部超音波室, 2神戸市立中央市民病院消化器センター内科

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

キーワード : Hepatic tumor, Color Doppler, FFT analysis, Pulsatility index (PI)

This study was performed to evaluate the usefulness of FFT analysis obtained by color Doppler flow imaging in the differential diagnosis of hepatic tumors. The color Doppler flow imaging (Toshiba SSA-270A or 260A or SSH-140A, Transducer 3.75 MHz or 5 MHz) acompanied with FFT analysis of intratumoral flow signal were performed on a total of 101 hepatic tumors in 99 patients consisting of 74 hepatocellular carcinomas (HCCs) (73 patients), 17 metastases (16 patients), and 10 hemangiomas (10 patients). The waveform, maximum velocity, and pulsatility index (PI) were evaluated in each hepatic nodule. Out of 74 HCCs, pulsatile waveform signal was detected in 62 (84%) , continuous waveform signal was detected in 8 HCCs (11%) , and both pulsatile and continuous waveform signals were detected in 4 HCCs (5%). Out of 17 metastases, 12 nodules (71%) had pulsatile waveform signals, 3 (17%) had continuous waveform signals, and 2 (12%) had both pulsatile and continuous waveform signals. Out of 10 hemangiomas, 4 nodules (40%) , 5 nodules (50%), and one nodule (10%) had pulsatile and continuous, and both pulsatile and continuous waveform signals, respectively. All of tumors with maximum velocity of intratumoral color signal of more than 70 cm/sec were HCCs. Furthermore, most of the tumors less than 5 cm in diameter with maximum velocity of intratumoral color signal of the more than 50cm/sec were HCCs. Mean±SD of PI (control=1.31±0.24) in HCCs, metastases and hemangiomas were 1.41±0.61, 1.40±0.53, and 0.81±0.19. PI values in 42% (28/60) of HCCs, 21% (3/14), and 80% (4/5) of hemangiomas, were out of the normal renge. Some of 42% of the HCCs whose PI values were out of the normal range were above the normal range, and the others were below the normal range. PI values of 80% of the hemangiomas were below the normal values. Maximum velocity of the continuous waveform signals of HCCs, metastases, and hemangiomas were 7.3±3.1 cm/sec, 6.2±2.2 cm/sec, and 5.1±2.3 cm/sec, respectively. We have concluded that differential diagnosis with FFT analysis conbined with color Doppler flow imaging is useful in the noninvasive differential diagnosis between HCCs, metastases, and hemangiomas.