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


Journal of Medical Ultrasonics

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1992 - Vol.19

Vol.19 No.10

Original Article(原著)

(0676 - 0684)

2 cm以下の肝内高エコー病変の鑑別診断とその自然経過の検討 −肝癌の早期診断を目的として−

Ultrasonographic Features and Natural History of Hyperechoic Lesions Smaller Than Two Centimeters with Regard to Diagnosis of Hepatocellular Carcinoma

小野 直美, 孫 順徳, 池田 敏, 福本 四郎

Naomi ONO, Juntoku SON, Satoru IKEDA, Shirou FUKUMOTO


The Second Department of Internal Medicine, Shimane Medical University

キーワード : Ultrasonography, Hyperechoic Lesion, Hepatocellular Carcinoma, Natural History, Small Liver, Cancer

We studied 62 cases, which had one or two hyperechoic lesions smaller than 2 cm in diameter in the liver, to determine the most useful clinical means of diagnosing small liver cancer. 39 subjects had histologicallyproved chronic liver disease. The other subjects were not examined histologically and liver function test was abnormal in 3 of them, while it was normal in 20 of them. Of the chronic liver disease cases, 10(12 lesions) hepatocellular carcinoma (HCC), 4 hemangioma, 2 regenerative nodule and 2 focal fatty change cases were diagnosed. No HCC was found in a patient without chronic liver disease. These lesions were observed repeatedly by ultrasonography for more than one year. Enlargement of the lesion was seen in the all HCCs. The hemangiomas, regenerative nodules and focal fatty changes disappeared or remained unchanged. 24 lesions, which disappeared or remained unchanged, were considered to be clinically benign lesios although they were not examined histologically. We compared ultrasonographic features of these clinically benign lesions and those of HCCs, only the tumor size was significantly different at initial examination. 22 clinically benign lesions were smaller than 10 mm in diameter, while the rest, 2 lesions, were bigger than 11 mm. However, 8 HCCs were bigger than 11 mm, while the rest, 4 HCCs, were smaller than 10 mm. Shape, brightness, density, boundary, internal hypoehoic area and halo were evaluated about the initial sonographic image but there were no significant differences between HCC and other lesions. During the follow-up, halo and internal hypoechoic area appeared gradually in some HCCs. We came to the conclusion that aimed biopsy is recommended for chronic liver disease patients when the small hyperechoic lesion is enlarging and/or when the lesion is bigger than 11 mm in diameter. Periodic ultrasonographic check is important to detect any changes in the lesion.