杤尾 人司¹, 簑輪 和士¹, 冨田 周介², 工藤 正俊², 島田 啓子¹, 豼オ逕ー 充生¹, 樫田 博史², 岡部 純弘², 三村 純², 豼オ逕ー 一美¹, 平佐 昌弘², 伊吹 康良², 小森 英司², 織野 彬雄², 森本 義人¹, 藤堂 彰男²

Hitoshi TOCHIO¹, Kazushi MINOWA¹, Syusuke TOMITA², Masatoshi KUDO², Keiko SHIMADA¹, Michio HAMADA¹, Hiroshi KASHIDA², Yoshihiro OKABE², Jun MIMURA², Kazumi HAMADA¹, Masahiro HIRASA², Yasuyoshi IBUKI², Hideshi KOMORI², Akio ORINO², Yoshito MORIMOTO¹, Akio Todo²

¹神戸市立中央市民病院臨床病理科腹部超音波室, ²神戸市立中央市民病院消化器センター内科

¹Section of Abdominal Utlrasound, Kobe City General Hospital, ²Division of Gastroenterology, Kobe City General Hospital

キーワード : Hepatic tumor, Color Doppler, FFT analysis, Pulsatility index (PI)

This study was performed to evaluate the usefulness of FFT analysis obtained by color Doppler flow imaging in the differential diagnosis of hepatic tumors. The color Doppler flow imaging (Toshiba SSA-270A or 260A or SSH-140A, Transducer 3.75 MHz or 5 MHz) acompanied with FFT analysis of intratumoral flow signal were performed on a total of 101 hepatic tumors in 99 patients consisting of 74 hepatocellular carcinomas (HCCs) (73 patients), 17 metastases (16 patients), and 10 hemangiomas (10 patients). The waveform, maximum velocity, and pulsatility index (PI) were evaluated in each hepatic nodule. Out of 74 HCCs, pulsatile waveform signal was detected in 62 (84%) , continuous waveform signal was detected in 8 HCCs (11%) , and both pulsatile and continuous waveform signals were detected in 4 HCCs (5%). Out of 17 metastases, 12 nodules (71%) had pulsatile waveform signals, 3 (17%) had continuous waveform signals, and 2 (12%) had both pulsatile and continuous waveform signals. Out of 10 hemangiomas, 4 nodules (40%) , 5 nodules (50%), and one nodule (10%) had pulsatile and continuous, and both pulsatile and continuous waveform signals, respectively. All of tumors with maximum velocity of intratumoral color signal of more than 70 cm/sec were HCCs. Furthermore, most of the tumors less than 5 cm in diameter with maximum velocity of intratumoral color signal of the more than 50cm/sec were HCCs. Mean±SD of PI (control=1.31±0.24) in HCCs, metastases and hemangiomas were 1.41±0.61, 1.40±0.53, and 0.81±0.19. PI values in 42% (28/60) of HCCs, 21% (3/14), and 80% (4/5) of hemangiomas, were out of the normal renge. Some of 42% of the HCCs whose PI values were out of the normal range were above the normal range, and the others were below the normal range. PI values of 80% of the hemangiomas were below the normal values. Maximum velocity of the continuous waveform signals of HCCs, metastases, and hemangiomas were 7.3±3.1 cm/sec, 6.2±2.2 cm/sec, and 5.1±2.3 cm/sec, respectively. We have concluded that differential diagnosis with FFT analysis conbined with color Doppler flow imaging is useful in the noninvasive differential diagnosis between HCCs, metastases, and hemangiomas.