松崎 浩司¹, 長山 徹¹, 伊原 文恵¹, 瓜田 純久¹, 飯田 和成¹, 成木 行彦¹, 大塚 幸雄¹, 山崎 和子²

Hiroshi MATSUZAKI¹, Toru NAGAYAMA¹, Fumie IHARA¹, Yoshihisa URITA¹, Kazunari IIDA¹, Yukihiko NARUKI¹, Sachio OOTSUKA¹, Kazuko YAMAZAKI²

¹東邦大学第1内科, ²東邦大学第1内科超音波室

¹First Department of Internal Medicine, School of Medicine, Toho University, ²Department of Ultrasonic Laboratory, Toho University

キーワード : Portal-Angio・Echo, Portal Vascularity, Carbon Dioxide, Hepatocellular Carcinoma

Trial and assessment of Angio・Echo under portography was undertaken by infusing carbon dioxide into the superior mesenteric artery (Portal-Angio・Echo) in patients suffering from hepatocellular carcinoma (HCC). The subjects were six cases of HCC, diagnosed by ultrasonography and CT, and were treated from March to October, 1992. The tumor diameters were measured 1.5∼8 cm, with an average of 4.7 cm. In our method, physiological saline (20 ml) with nicardipine hydrochloride (4 mg) and heparin added was infused from the superior mesenteric artery, 30 seconds later, a mixture of CO₂ gas (20∼30 cc) and the patient's blood (10 ml), or a mixture of Intralipid (30 ml) and CO₂ gas (30 cc) was infused in about 10 seconds. Ultrasonotomographic images of the tumors were recorded on video tape. The inner parts of the tumors showed negative enhancement, from the early to late phases, in all six cases. In the five cases having a halo site, enhancement was negative in all five cases, moreover the contrast with the normal hepatic tissue became increasingly remakable in all five cases. In two of these cases, expansion of a low echoic site, which extended from a part of the halo site, could be observed. It was considered that Portal-Angio・Echo is useful for investigating grasping the portal hemodynamics of HCC and for its qualitative diagnosis.