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英文誌(2004-)

Journal of Medical Ultrasonics

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2000 - Vol.27

Vol.27 No.11

Original Article(原著)

(1415 - 1425)

カラードプラ法による各種腸疾患の血流動態の検討

Blood Flow in Various Bowel Diseases Investigated by Color Doppler Sonography

岩崎 信広1, 岡部 純弘2, 杤尾 人司1, 中村 仁美1, 太田 圭子1, 曽我 登志子1, 藤本 敏明1, 森本 義人1, 岡田 明彦2, 樫田 博史2, 平佐 昌弘2, 伊吹 康良2, 小西 豊3, 冨田 周介4, 織野 彬雄2

Nobuhiro IWASAKI1, Yoshihiro OKABE2, Hitoshi TOCHIO1, Hitomi NAKAMURA1, Keiko OOTA1, Toshiko SOGA1, Toshiaki FUJIMOTO1, Yoshito MORIMOTO1, Akihiko OKADA2, Hiroshi KASHIDA2, Masahiro HIRASA2, Yasuyosi IBUKI2, Yutaka KONISHI3, Syusuke TOMITA4, Akio ORINO2

1神戸市立中央市民病院腹部超音波検査室, 2神戸市立中央市民病院消化器センター内科, 3神戸市立中央市民病院外科, 4冨田クリニック

1Department of Abdominal Ultrasound, Kobe City General Hospital, 4-6 Minatojima Nakamachi, Chuo-ku, Kobe 650-0046, Japan, 2Department of Gastroenterology, Kobe City General Hospital, 4-6 Minatojima Nakamachi, Chuo-ku, Kobe 650-0046, Japan, 3Department of Surgery, Kobe City General Hospital, 4-6 Minatojima Nakamachi, Chuo-ku, Kobe 650-0046, Japan, 4Tomita Clinic

キーワード : Blood flow, Color Doppler sonography, Intestinal diseases

We used color Doppler sonography (CD) to evaluate blood flow and thickening of the wall of the intestine in various bowel diseases in an attempt to evaluate the clinical usefulness of CD for diagnosing various bowel diseases. Two hundred fifty-six patients were studied: 148 had bacterial colitis (BC); 19, ischemic colitis (IC); 10, ulcerative colitis (UC); 13, Crohn's disease (Cd); 4, drug-associated hemorrhagic colitis (DC); 2, Schönlein-Henoch disease; 11, diverticulitis; 32, appendicitis; and 17, advanced colon cancer. Fifty healthy individuals served as controls. The quantity of color flow signals as well as peak flow velocity, pulsatility index, and resistance index were measured in the patients and compared with corresponding values obtained from the healthy controls. BC, UC, and Cd produced readily visible rich flow signals in their early stages. In hemolytic uremic syndrome associated with verotoxin-producing infection by E coli, the echo level in the cortex of the kidney was elevated at first, and blood flow was markedly reduced. In the convalescent stage, blood flow increased and echo level declined. Flow signals were barely visible or absent in the early stages of IC and DC. Diverticulitis of the colon is characterized by arterial flow signals that appear as an arch in the diverticular wall. Quantity of color flow signals in acute appendicitis corresponded closely with grade of inflammatory process. Rich flow signals were detected in 17 patients with advanced colon cancer. Peak velocity, pulsatility index, and resistance index of these pulstile flow signals were 29.9±20.0 cm/s, 2.08±0.80, and 0.84±0.15, respectively. Arterial flow parameters in advanced colon cancer differed significantly from those in the other bowel diseases. These results suggest that CD could play an important role in the hemodynamic diagnosis of various bowel diseases.