金澤 真作¹, 緒方 秀昭¹, 三塚 幸夫², 馬越 俊輔¹, 齋藤 芙美¹, 伊東 俊秀¹, 白神 伸之³, 根本 哲生⁴, 渋谷 和俊⁴, 金子 弘真¹

Shinsaku KANAZAWA¹, Hideaki OGATA¹, Yukio MITSUZUKA², Shunsuke MAGOSHI¹, Fumi SAITO¹, Toshihide ITO¹, Nobuyuki SHIRAGA³, Tetsuo NEMOTO⁴, Kazutoshi SHIBUYA⁴, Hironori KANEKO¹

¹東邦大学医学部外科学講座（大森）一般・消化器外科, ²東邦大学医療センター大森病院臨床生理機能検査部, ³東邦大学医療センター大森病院放射線診断部, ⁴東邦大学医療センター大森病院病院病理部

¹Division of General and Gastroenterological Surgery, Department of Surgery (Omori), Toho University School of Medicine, ²Department of Clinical Functional Physiology, Toho University Medical Center Omori Hospital, ³Department of Radiology, Toho University Medical Center Omori Hospital, ⁴Department of Pathology, Toho University Medical Center Omori Hospital

キーワード : breast ultrasound, contrast-enhanced ultrasound, perfusion image, vascular image, Sonazoid

目的：乳腺疾患に対して第二世代超音波造影剤Sonazoid^®を用いた造影超音波を行い，その特徴と意味を検討した．対象と方法：造影超音波が行われ，組織診断が確定した乳癌97病変と良性30病変を検討対象とした．Sonazoid^®は混濁液として0.0075 mg/kgを静脈内投与し，Pulse Subtraction low Mechanical index modeやMicro flow imagingで観察した．結果と考察：微小気泡の共鳴信号を高い時間空間分解能で画像化する造影超音波により，微細な染影や細かい血管走行の描出が可能であった．染影は病変内部の不均一性を反映し，病変周囲に限局した染影は浸潤性発育に伴う腫瘍血管の存在を示し浸潤癌に特徴的な所見であった．血管走行は病変の発育形態を反映し，良性病変では多数の分枝を持つのに対し，悪性病変では分枝に乏しい走行を示した．結論：乳腺造影超音波では病変の微細な構造を観察することが可能であった．

Purpose: We performed contrast-enhanced ultrasound for breast disease using the second-generation contrast agent Sonazoid^® to investigate characteristic findings and its meaning. Subjects: Subjects were 97 breast cancer lesions and 30 benign lesions confirmed by tissue diagnosis after contrast-enhanced ultrasound was conducted. Sonazoid^® was observed by low-mechanical-index pulse subtraction imaging and micro flow imaging. Results and Discussion: Because contrast-enhanced ultrasound could image the resonance signal of the micro air bubbles in high time and spatial resolution, the depiction of a minute perfusion image and a small vascular image was possible. The perfusion image reflected the uniformity in the lesion, and the neighboring perfusion image showed the presence of the tumor vessel with infiltrative growth, a finding peculiar to an invasive cancer. The vascular image reflected the growth form of the lesion. The malignant lesion showed a little vascular image in the branch, whereas the benign lesion had a large number of branches on contrast-enhanced ultrasound. Conclusion: We were able to examine the minute structure of the lesion by contrast-enhanced ultrasound of the breast using Sonazoid^®.