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英文誌(2004-)

Journal of Medical Ultrasonics

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1986 - Vol.13

Vol.13 No.03

Original Article(原著)

(0173 - 0182)

胆管癌における超音波検査の意義—特に浸潤範囲の診断能について—

Evaluation of Ultrasonography in Bile Duct Cancer, with Special Reference of Its Extension

堀口 祐爾1, 大漉 正夫1, 北野 徹1, 田口 寛子1, 今井 英夫1, 伊藤 圓1, 宮川 秀一2, 中村 従之2, 鄭 統圭2

Yuji HORIGUCHI1, Masao OOSUKI1, Tohru KITANO1, Hiroko TAGUCHI1, Hideo IMAI1, Madoka ITOH1, Syuichi MIYAKAWA2, Yoriyuki NAKAMURA2, Tokei TEI2

1藤田学園保健衛生大学消化器内科, 2藤田学園保健衛生大学外科

1Division of Gastroenterology, FujitaGakuen Health University School of Medicine, 2Department of Surgery, FujitaGakuen Health University School of Medicine

キーワード : Bile duct cancer, Ultrasonography, Tumor invasion, Tumor extension

 Ultrasonography (US) is the most useful modality not only for diagnosis of obstructive jaundice but also for detection of bile duct tumor. In this paper, we tried to clarify the ultrasonographic features of extrahepatic bile duct cancer and then evaluate preoperative predictability of the tumor extension in 37 cases, including 21 of the upper bile duct cancer and 13 of the middle bile duct cancer.
 The mass was demonstrated in 31 (83.8%), the echo level of that was hyperechoic in 17 cases (54.8%) and hypoechoic in 8 (25.8%). The mean size of hyperechoic mass was 2.8±1.5 cm, which was smaller than that of the hypoechoic mass (4.3±0.7 cm). But the echo level of the tumor was not correlative with the location or macroscopic findings.
 The tumor could be resected in 21 cases. We compared the sonogram with macroscopic findings of the resected specimen in 8 lesions which could be demonstrated clearly by US. In most of cases, serosal infiltration (S) and direct invasion to the liver (Hinf) could be evaluated from the sonographic findings such as disappearance or discontinuation of bile duct wall. But the evaluation of serosal and hepatic infiltration was failed in diffusely infiltrating type, and depth and spread of intramural invasion could not be assessed by US.
 From these results, US has facilitated to predict extramural extension of the tumor to some extent especially in nodular and papillary type cancer.