倉井 順子¹, 大澤 正明¹, 武井 ひろみ¹, 宮澤 義¹, 秋葉 新¹, 嶋田 勇¹, 谷口 信行²

Junko KURAI¹, Masaaki OOSAWA¹, Hiromi TAKEI¹, Tadashi MIYAZAWA¹, Shin AKIBA¹, Isamu SHIMADA¹, Nobuyuki TANIGUCHI²

¹自治医科大学附属病院臨床検査部, ²自治医科大学附属病院臨床検査医学

¹Division of Clinical Laboratory Medicine, Jichi Medical University Hospital, ²Division of Clinical Laboratory Medicine, Jichi Medical University Hospital

キーワード : echocardiography, examinee position, examination

目的：被検者の臥位方向による心エコー描出能について比較検討した．対象および方法：心エコー検査を施行した健常者と心疾患を有する患者の計50名を対象とした．方法は心エコー検査時の被検者の頭尾部の向きについて，被検者の頭側が検者の腹側に位置する左側臥位（通常法）と，頭側が検者の背側に位置する左側臥位（検討法）の両者間で，弁の逆流，大動脈径，左心房径，心室中隔厚，左室後壁厚，拡張末期径，収縮末期径，左室駆出分画，右室流出血流速，三尖弁逆流最高流速，E波・A波最高流速，E/A，左室駆出血流速，下大静脈径について測定し，両者の測定値に差があるかどうかを検討した．また，15名については通常法後に検討法（通常法先）を，検討法後に通常法（検討法先）と検査順番を変えて両方法間での有意差の有無を各々比較検討した．19名の被検者に両法についてのアンケートを行った．結果：健常者群，疾患群共に全ての項目で通常法と検討法の間に有意差を認めなかった．また，通常法先でも検討法先でも，共に有意差を認めなかった．アンケート調査では，検討法についてモニタが見えてよい，検査時にモニタの観察を希望すると回答する割合が最も多かった．結語：通常法と検討法の両者間に有意差が見られなかった事より，心エコー検査は検査状況により検査体位を選択することが可能と考える．

Purpose: To compare echocardiographic findings by examinee position. Subjects and Methods: The subjects were 50 healthy and heart-diseased patients who visited our ultrasound laboratory for echocardiography. For comparison, we applied two methods: one in which the examinee′s head was located on the anterior side of the examiner and one in which it was located on the posterior side of the examiner. In both methods, we measured the degree of valvular regurgitation, diameters of the aorta and left atrium, wall thickness of the septum and posterior wall, left ventricular dimensions in diastole and systole velocities of E and A wave, E/A ratio, peak systolic flow velocity of the left ventricular outflow tract, and inferior vena cava dimensions. To evaluate the bias in examination order, 15 subjects were examined by the former method first and 15 subjects were examined by the latter method first. We also asked 19 examinees several questions about both methods. Results: There were no significant differences between the two methods for any of the measured values. No difference was found regardless of which method had been done first. In terms of the questions to examinees, the biggest merit was that they could see the monitor during the examination. Conclusion: There was no significant difference between two methods. The patient position during echocardiography should be selected according to the examination conditions.