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英文誌(2004-)

Journal of Medical Ultrasonics

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2003 - Vol.30

Vol.30 No.06

Case Report(症例報告)

(J743 - J748)

特徴的なパワードプラエコー所見を呈した肝限局性結節性過形成(肝FNH)の2例

Two Cases of Hepatic Focal Nodular Hyperplasia (FNH) with Characteristic Power Doppler Ultrasonography Findings

矢島 浩2, 蝨句悄 典宏3, 関 誠1, 高橋 孝4

Hiroshi YAJIMA2, Norihiro KOKUDO3, Makoto SEKI1, Takashi TAKAHASHI4

1癌研究会附属病院消化器外科, 2現東京慈恵会医科大学外科, 3現東京大学医学部肝胆膵外科, 4現千葉医療生命科学総合病院

1Department of Digestive Surgery, Cancer Institute Hospital, 2Department of Surgery, Jikei University School of Medicine, 3Department of Hepatobiliary Pancreatic Surgery, University of Tokyo, 4Chiba Medical Life Science General Hospital

キーワード : focal nodular hyperplasia, liver, power Doppler ultrasonography, spoke-wheel appearance

パワードプラエコーで特徴的な車軸状血管像(spoke-wheel appearance)を呈した肝限局性結節性過形成(肝FNH)の2例を経験したので報告する. 症例1, 38歳女性. 症例2, 34歳女性. 2例はともに検診の腹部超音波検査で肝腫瘤を指摘され, 当科受診となった. 腹部超音波検査(Bモード)で症例1は肝S3に径約6 cmの低エコー腫瘤を, 症例2は肝S3に径約6 cmの高エコー腫瘤を認めた. 2例はともにパワードプラ法では車軸状血管像が描出され, 肝FNHと診断された. ドプラエコーは血管造影と異なり, 簡便で経済効率も良くかつ非侵襲的に施行可能である. 車軸状血管像の描出にパワードプラ法が有用であった肝FNHの典型例2例を報告した.

Abdominal power Doppler ultrasonography showed the characteristic spoke-wheel blood-flow signal in two cases of focal nodular hyperplasia of the liver. Hepatic masses were detected in two patients by previous abdominal ultrasonography during routine medical check-ups. These patients were referred to this institution. Case 1 was presented by a woman aged 38 years. Abdominal gray scale ultrasonography visualized a hypoechoic mass 6 cm in diameter in the left lateral segment of the liver. In case 2, presented by a woman aged 34 years, abdominal gray scale ultrasonography visualized a hyperechoic mass 6 cm in diameter in the left lateral segment of the liver. Both cases showed the spoke-wheel pattern in power Doppler ultrasonograms. Those two cases were diagnosed as focal nodular hyperplasia. Power Doppler ultrasonography is easy to perform, inexpensive, and non-invasive, compared with angiography. Application of power Doppler ultrasonography to the liver mass could prove useful for its ability to detect the spoke-wheel pattern that typifies the focal nodular hyperplasia lesion.