1Department of Internal Medicine, Saiseikai Nara Hospital, 2Department of Radiology, Saiseikai Nara Hospital, 3Department of Clinical Labolatory, Saiseikai Nara Hospital, 4Department of Internal Medicine, Heisei Memorial Hospial, 5Department of Endoscopy and Ultrasound, Nara Medical University, 6The second Department of Internal Medicine, Nara Medical University
We encountered a case of squamous cell carcinoma of the lung in which Sonazoid®-enhanced ultrasonography using coded phase inversion (CPI) mode and coded harmonic angio (CHA) mode appeared to be useful for enhancing tumor vessels. A tumor shadow in S6 of the right lung was detected in an 85-year-old woman. She was diagnosed with squamous cell carcinoma of the lung with ultrasonography-guided needle biopsy. B-mode showed a hypoechoic tumor with pleural invasion. Color Doppler, power Doppler sonography, and B-flow color showed tortuous and bronchial color flow inside and around the tumor. Sonazoid® (GE Health Care, Oslo, Norway) is a second-generation sonographic contrast agent. A 0.4-ml dose of Sonazoid® was injected into an antecubital vein, which was half the recommended dose.CPI mode imaging software is a low mechanical index, and CHA mode imaging software is a high mechanical index. CPI mode images obtained after injection of Sonazoid® showed more flow signals both inside and around the tumor. But the spatial resolution was poor. Another 0.4-ml dose of Sonazoid® was injected. CHA mode images obtained after injection of Sonazoid® showed more and clearer flow signals both inside and around the tumor.