浜崎 直樹¹, 塩谷 直久¹, 今井 照彦², 林田 幸治³, 安川 元章⁴, 川口 剛史⁴, 太地 良佑⁵, 高濱 潤子⁵, 丸上 永晃⁶, 平井 都始子⁶

Naoki HAMAZAKI¹, Naohisa SHIOYA¹, Teruhiko IMAI², Kouji HAYASHIDA³, Motoaki YASUKAWA⁴, Goushi KAWAGUCHI⁴, Ryosuke TAIJI⁵, Junko TAKAHAMA⁵, Nagaaki MARUGAMI⁶, Toshiko HIRAI⁶

¹塩谷内科診療所, ²済生会奈良病院内科, ³済生会奈良病院臨床検査部, ⁴奈良県立医科大学胸部・心臓血管外科, ⁵奈良県立医科大学放射線科, ⁶奈良県立医科大学総合画像診断センター

¹Shioya Clinic of Internal Medicine, ²Department of Internal Medicine, Saiseikai Nara Hospital, ³Department of Clinical Laboratory, Saiseikai Nara Hospital, ⁴The Department of Thoracic and Cardiovascular Surgery, Nara Medical University, ⁵The Department of Radiology, Nara Medical University, ⁶The Department of General Diagnostic Imaging Center, Nara Medical University

キーワード : respiratory ultrasound, shear wave elastography, lung cancer, pneumonia, shear wave velocity

呼吸器領域におけるエラストグラフィは，strain法が気管支超音波（EBUS）で縦隔や肺門リンパ節の評価に臨床応用された報告を散見するが，shear wave elastographyの報告はほとんどない．このたび我々は体表からのアプローチでshear wave elastographyを用いてせん断波伝搬速度を測定しえた胸膜に接する肺内病変（胸膜下病変）の肺扁平上皮癌1例と肺炎1例を経験した．両症例ともせん断波伝搬速度は安定して測定された．肺扁平上皮癌のせん断波伝搬速度は肺炎のせん断波伝搬速度より明らかに速かった．胸膜に接する病変において体表からのアプローチでshear wave elastographyによりせん断波伝搬速度が測定可能であり，診断への有用性を示唆している．

In the case of respiratory diseases, the have been some reports of strain elastography in endobronchial ultrasonography (EBUS) for evaluating the mediastinal and hilar lymph nodes, but there are few reports of use of shear wave elastography. We encountered a case of lung cancer (squamous cell carcinoma) and a case of pneumonia adjacent to the pleura in which shear wave velocity could be reliably measured by shear wave elastography from the body surface. We found that the shear wave velocity of lung cancer was faster than that of pneumonia. These findings demonstrate that the shear velocity of subpleural lung lesions can be measured by shear wave elastography from the body surface. These findings also show that shear wave elastography may be useful for the diagnosis of subpleural lung lesions.