浜崎 直樹¹, 江川 信一¹, 竹下 修治¹, 仲川 房幸², 空 昭洋³, 吉田 和弘³, 鴻池 義純⁴, 今井 幸子⁵, 平井 都始子⁶, 成田 亘啓⁷

Naoki HAMAZAKI¹, Shinichi EGAWA¹, Shuuji TAKESHITA¹, Fusayuki NAKAGAWA², Akihiro SORA³, Kazuhiro YOSHIDA³, Yoshizumi KOUNOIKE⁴, Yukiko IMAI⁵, Toshiko HIRAI⁶, Nobuhiro NARITA⁷

¹済生会奈良病院内科, ²済生会奈良病院放射線科, ³済生会奈良病院臨床検査部, ⁴平成記念病院内科, ⁵奈良県立三室病院放射線科, ⁶奈良県立医科大学腫瘍放射線科, ⁷奈良県立医科大学第2内科

¹Department of Internal Medicine, Saiseikai Nara Hospital, ²Department of Radiology, Saiseikai Nara Hospital, ³Department of Clinical Laboratory, Saiseikai Nara Hospital, ⁴Department of Internal Medicine, Heisei Memorial Hospital, ⁵Department of Radiology, Nara Prefectural Mimuro Hospital, ⁶Department of Oncoradiology, Nara Medical University, ⁷Second Department of Internal Medicine, Nara Medical University

キーワード : color Doppler ultrasonography, intravenous contrast agent, levovist, power mode, lung cancer

We recently encountered two cases that suggested that Levovist, an intravenous contrast agent, was useful for its ability to enhance color signals in the color Doppler ultrasonographic imaging in subpleural lung cancer, especially in lung cancer with relatively poor flow and tortuous color flow in part of the lesion. Case 1 was that of a 66-year-old woman in whom a tumor shadow was detected in S¹⁺² of the left lung. The diagnosis of squamous cell carcinoma of the lung was based on the results of broncoscopic examination. The B-mode ultrasonogram showed a hypoechoic tumor with pleural invasion. Power Doppler US color flow patterns indicated tortuous color flow in part of the lesion. Power Doppler ultrasonograms acquired after injection of Levovist showed enhanced color flow signals inside and around the periphery of the tumor. Color flow signals increased from the partial to the whole type. Case 2 was that of a 69 year-old man with a mass shadow in S¹⁺² of the left lung. The diagnosis of squamous cell carcinoma of the lung was based on results of broncoscopic examination. The B-mode ultrasonogram showed a hypoechoic tumor with pleural invasion. The power Doppler US color flow pattern indicated tortuous color flow in part of the lesion. Power Doppler ultrasonograms acquired after injection of Levovist showed enhanced color flow inside and around the periphery of the tumor. Color flow pattern did not change after injection of Levovist . These two cases suggest that Levovist is useful in detecting the vessels of subpleural lung cancer.