田中 弘教, 飯島 尋子

Hironori TANAKA, Hiroko IIJIMA

兵庫医科大学超音波センター

Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine

キーワード : ultrasonography, Sonazoid, liver tumor, HCC, contrast-enhanced ultrasonography

腫瘍性肝病変の超音波診断はBモードやドプラ法の改善，造影超音波の技術の進歩と共に日進月歩で発展してきた．また，最近の3D技術の進歩も目覚ましく，腹部領域においても実用段階への道が開けてきた．腫瘍性肝疾患の画像診断では，2008年に登場したEOB-MRIは，その感度の高さより診断の位置付けを変えつつある．しかし，低侵襲で時間及び空間分解能に優れる超音波検査の有用性は揺るぎない．超音波診断は肝腫瘍のスクリーニングに不可欠であり，確実な画像診断が要求される．そのために，常に最新の知識をもって検査を行う必要がある．本稿では，腫瘍性肝疾患の中で最も重要な，肝細胞癌，肝内胆管癌，転移性肝癌，血管腫，限局性結節性過形成（FNH），肝細胞腺腫について，専門的かつ実践的な超音波診断を，これまでの報告に加え最新の知見を概説した．

Use of ultrasonography (US) in diagnosing liver tumors has advanced with improvements in B-mode, color Doppler, and contrast enhancement methods. Similarly remarkable advances in three dimensional technology achieved during the past ten years are expected to find clinical use soon. Further, striking progress is also being made in CT and MRI technology. The importance of US is made unshakable, however, by its minimal invasiveness, high spatial and time resolution, and low cost. Because diagnosis of liver tumor is the most important role for US, sonographers should strive to gain up-to-date knowledge of its application. In this review, we explain the differential diagnosis of such tumors as hepatocellular carcinoma, intrahepatic cholangioma, metastatic liver tumor, hemangioma, focal nodular hyperplasia (FNH), and liver adenoma.