鯉江 伸¹, 松山 裕宇¹, 岩瀬 正嗣¹, 武田 京子², 加藤 千博¹, 長谷川 和生¹, 木村 美由紀¹, 野村 雅則¹, 小出 章博¹, 山本 春光¹, 畑田 綾子¹, 渡辺 佳彦¹, 菱田 仁¹

Shin KOIE¹, Hiroyuki MATSUYAMA¹, Masatsugu IWASE¹, Kyoko TAKEDA², Chihiro KATO¹, Kazuo HASEGAWA¹, Miyuki KIMURA¹, Masanori NOMURA¹, Akihiro KOIDE¹, Harumitsu YAMAMOTO¹, Ayako HATADA¹, Yoshihiko WATANABE¹, Hitoshi HISHIDA¹

¹藤田保健衛生大学医学部内科, ²名古屋記念病院循環器科

¹Department of Internal Medicine, Fujita Health University, ²Division of Cardiology, Nagoya Memorial Hospital

キーワード : Autopsy , Intravascular ultrasound (IVUS) , Pulmonary thromboembolism

We attempt to clarify those intravascular ultrasound (IVUS) findings indicative of fresh and chronic pulmonary thromboemboli (PTE). Method: We studied PTE in the acute and chronic phases in 14 clinical and 7 autopsy cases of IVUS imaging using a 20 MHz mechanical transducer. Results: In the acute phase, large PTE attached to the proximal pulmonary artery were depicted as echolucent masses with irregular echogenic surfaces protruding into the lumens, which the IVUS findings confirmed in autopsy cases of acute PTE. Two subacute cases showed PTE that appeared as slightly echolucent crescent-shaped masses with smooth echogenic surfaces that narrowed the lumens. Chronic recurrent PTE associated with pulmonary hypertension had a highly echogenic crescent-shape with partial bulging of the vessel wall at the site of persistent thrombi. Similar highly echogenic images of PTE were noted also in the autopsy cases of chronic PTE. Conclusion: IVUS can be used to distinguish between acute and chronic PTE.