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英文誌(2004-)

Journal of Medical Ultrasonics

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2016 - Vol.43

Vol.43 No.Supplement

特別プログラム 消化器
パネルディスカッション 消化器 Joint2(JSUM・AFSUMB・ACUCI Joint Session)(English) 肝癌診療における造影超音波診断

(S346)

DEB-TACEにおける術中造影超音波による評価とB-modeによる治療後の変化の観察

Availability of contrast-enhanced ultrasonography during DEB-TACE and the variation of imaging appearance after DEB-TACE on ultrasonography

熊川 まり子, 小川 眞広, 渡邊 幸信, 高安 賢太郎, 平山 みどり, 三浦 隆生, 松本 直樹, 中河原 浩史, 松岡 俊一, 森山 光彦

Mariko KUMAGAWA, Masahiro OGAWA, Yukinobu WATANABE, Kentaro TAKAYASU, Midori HIRAYAMA, Takao MIURA, Naoki MATSUMOTO, Hiroshi NAKAGAWARA, Shunichi MATSUOKA, Mitsuhiko MORIYAMA

日本大学医学部消化器肝臓内科

Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine

キーワード :

【Objects】
Blood flow changes of hepatocellular carcinoma(HCC)during transarterial chemoembolization with drug-eluting bead(DEB-TACE)can be observed by contrast-enhanced ultrasonography(CEUS). The aim of this study is to demonstrate the changes of grayscale findings before and after DEB-TACE.
【Methods】
We recruited three patients with HCC(two men, one woman; median age, 66 years)who received DEB-TACE on December 2015 in our hospital. All lesion located at right lobe and median size was 27(18-38)mm. Drugs for DEB-TACE were DC Bead®(Eisai)and Epirubicin(Pfizer). We used LOGIQ S8(GE healthcare Japan)for grayscale US and CEUS. Grayscale US was conducted before, and post-DEB-TACE(6 hour later, day 1,3 and 7). CEUS was performed during DEB-TACE 2-4 times; Sonazoid®(Daiichi-Sankyo)injected as a 0.2-ml, and we take examination recording from 15 to 60 sec(Mechanical index= 0.4). In addition, CEUS was performed on day 3 or 7. CEUS imaging during DEB-TACE was compared to post- DEB-TACE and contrast-enhanced computed tomography(CT)performed at a month later.
【Results】
Case 1: In CEUS, remained vascularity of HCC could be observed as hyper-enhancement during DEB-TACE, and vascular lake was described as pooling of Sonazoid. On the day of DEB-TACE, grayscale US showed high echo area in a lesion. On day 3,grayscale imaging changed into low echo area. CEUS imaging at 6 hour later corresponded to that on day 7; there remained wedge-shaped hyper-enhancement. Treatment effect(TE)evaluated by contrast-enhanced CT at a month later was 3. Case 2: Remained vascularity of HCC could be observed as hyper-enhancement during DEB-TACE at CEUS. On the day of DEB-TACE, grayscale US showed high echo area in a lesion. On day 1,high echo area disappeared, and grayscale imaging changed into low echo area. In CEUS, hyper-enhancement remained at 6 hour later, and extinguished on day 7. TE evaluated by contrast-enhanced CT at a month later was 4. Case 3: CEUS findings could not be evaluate. There was no changing in grayscale US after DEB-TACE. TE evaluated by contrast-enhanced CT at a month later was 0.
【Conclusions】
CEUS may be useful for monitoring and early prediction of efficacy of DEB-TACE in patients with HCC. Grayscale findings changed after DEB-TACE over time.