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.