横田 京子¹, 尾本 きよか¹, 小野 倫子¹, 王 怡¹, 中村 みちる¹, 谷口 信行¹, 伊東 紘一¹, 松本 敦², 菊池 豊², 白石 裕比湖², 桃井 真里子², 兵頭 秀樹³, 上沢 修⁴

Kyoko YOKOTA¹, Kiyoka OMOTO¹, Tomoko ONO¹, Yi WANG¹, Michiru NAKAMURA¹, Nobuyuki TANIGUCHI¹, Kouichi ITOH¹, Atsushi MATSUMOTO², Yutaka KIKUCHI², Hirohiko SHIRAISHI², Mariko MOMOI², Hideki HYODOH³, Osamu KAMISAWA⁴

¹自治医科大学付属病院臨床検査部, ²自治医科大学付属病院小児科, ³自治医科大学付属病院放射線科, ⁴自治医科大学付属病院胸部外科

¹Department of Clinical Laboratory, Jichi Medical School, ²Department of Pediatrics, Jichi Medical School, ³Department of Radiology, Jichi Medical School, ⁴Department of Chest Surgery, Jichi Medical School

キーワード : Arteriovenous malformation, Color Doppler ultrasonography, Internal iliac vessels

A 13-year-old girl was admitted to the hospital because of cardiomegaly found incidentally at regular medical checkup at her school. Although dilated cardiomyopathy was suspected, the girl showed no symptoms. The chest x-ray film showed cardiomegaly (cardiothoracic ratio, 67%), and the echocardiogram demonstrated a dilatation of the left ventricle without thinning of the wall. While contraction was diffusely decreased, estimated cardiac output was increased to 12 l/minute. Abdominal ultrasonography conducted to clarify the cause of this high output showed a multicystic lesion (8×6×4 cm) at the back of the left common iliac artery. Color Doppler ultrasonography revealed abundant blood flow within the lesion, establishing the diagnosis of arteriovenous malformation. Aortography delineated the arteriovenous malformation being supplied from the left internal iliac artery and from the left third and fourth lumbar arteries and drainage into the left common iliac vein and the right internal iliac vein. Although it did not show the precise location of the feeding and draining vessels, color Doppler ultrasonography was useful for the diagnosis of arteriovenous malformation.