市川 博和

Hirokazu ICHIKAWA

西内病院外科超音波検査室

Section of Diagnostic Ultrasound and Surgical Clinic, Nishiuchi Hospital, 9-28 0htesuii Kochi-Shi 780

キーワード : pneumobilia, strong echo, acoustic shadow, echo pattern, linear electronic scan

Ultrasonic appearance of pneumobilia was obtained in 15 patients who underwent linear electronic scanning. Their plain roentgenograms showed pneumobilia in all patients. They were not only distinctly high level of echo with or without slight, weak acoustic shadow but also quickly moving strong echo at times, in the liver. Echo patterns of pneumobilia were classified into six types from each appearance of strong echo as follows, mixed pattern of type 6, scattering pattern of type 1, branching pattern of type 2, lined pattern of type 3, single pattern of type 4 and diffuse pattern of type 5 in order of frequency. In one patient with intrahepatic stone pneumobilia was produced by infused air through the indwelling T-tube. All six echo patterns as described above were observed also in this patient by scanning freely, different ultrasonic planes. One of those planes visualized both pneumobilia and intrahepatic stone simultaneously, which revealed nothing or slight, weak acoustic shadow posterior to the strong echo of pneumobilia, mostly to the edge but wide, strong shadow immediately posterior to that of stone. 　
Ultrasonic appearance of intrahepatic stone in other seven patients was same unipattern as described above throughout various scanning.