浜崎 直樹¹, 塩谷 直久¹, 平井 都始子², 丸上 永晃², 太地 良佑³, 安川 元章⁴, 川口 剛史⁴, 澤端 章好⁴, 柴 五輪男⁵, 今井 照彦⁵

Naoki HAMAZAKI¹, Naohisa SHIOYA¹, Toshiko HIRAI², Nagaaki MARUGAMI², Ryosuke TAIJI³, Motoaki YASUKAWA⁴, Goushi KAWAGUCHI⁴, Noriyoshi SAWABATA⁴, Iwao SHIBA⁵, Teruhiko IMAI⁵

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

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

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

目的：体表からのアプローチでshear wave elastographyの呼吸器疾患に対する有用性を評価する．対象：検討患者は合計13名，内訳は原発性肺癌6名，転移性肺癌2名，肺炎4名，無気肺1名．方法：体表から超音波Bモードで肺病変を描出し，shear wave elastographyを用いてせん断波伝搬速度を測定した．結果と考察：肺腫瘍のせん断波伝搬速度は3.26～7.25 m/sで平均4.86±1.29 m/sであった．肺炎・無気肺のせん断波伝搬速度は1.08～2.29 m/sで平均1.57±0.45 m/sであった．肺腫瘍のせん断波伝搬速度は肺炎・無気肺よりも明らかに速く，統計学的に有意差を認めた．結論：胸膜に接する肺病変において体表からのアプローチでshear wave elastographyが質的診断に有用である可能性が示唆された．

Purpose: Evaluation of the usefulness of shear wave elastography for respiratory diseases. Subjects: Thirteen patients including six primary lung cancers, two metastatic lung cancers, four pneumonias, and one atelectasis. Methods: The shear velocity of lung lesions depicted from the body surface by B-mode ultrasonography was measured by shear wave elastography. Results and Discussion: The shear velocity of lung tumors was 3.26～7.25 m/s (average: 4.86±1.29 m/s). The shear velocity of pneumonia and atelectasis was 1.08～2.29 m/s (average: 1.57±0.45 m/s). The shear velocity of lung tumors was apparently faster than that of pneumonia and atelectasis, and a significant difference was recognized. Conclusion: These findings suggest that shear wave elastography may be useful for the qualitative diagnosis of subpleural lung lesions from the body surface.