丸山 憲一

Kenichi MARUYAMA

東邦大学医療センター大森病院臨床生理機能検査部

Department of Clinical Functional Physiology, Toho University Medical Center Omori Hospital

キーワード : ultrasonographic examination, renal scanning methods, kidney observation points, screening

超音波検査は低侵襲で特別な環境を必要としないことから，人間ドックや集団検診から泌尿器科医が行う日常診療の現場にと，スクリーニング検査として幅広く用いられ，腎癌の早期発見に有用とされている．腎臓の検査にあたっては，まずは大きさ，形状，腎皮質および髄質のエコーレベル，腎洞の異常について着目しながら，腫瘤性病変の有無について観察するとよい．本稿では，初級者が腎臓の超音波検査を行うにあたって必要な基本的知識として，プローブの走査法と観察すべきポイント，そして日常検査で遭遇する機会が多い代表的疾患について，先天性異常（馬蹄腎等），腎不全，腎盂腎炎，尿路結石，嚢胞性疾患，腫瘍性病変（血管筋脂肪腫，腎細胞癌）の項目ごとに概説する．

Ultrasonography is a minimally invasive imaging modality used in routine clinical practice. No special environment is needed to perform this examination; therefore, it is widely used by urologists to perform comprehensive medical examinations and mass screenings, among other such procedures. Ultrasonography is an effective screening modality for early detection of renal cancer. A renal examination should include close observation of the size and shape of the kidneys and the echogenicity of the renal cortex and medulla. Clinicians should also carefully assess renal sinus abnormalities, as well as the presence of tumors. This paper describes the fundamental concepts and knowledge required for beginners to perform ultrasonographic examinations. Details regarding probe scanning methods, specific points requiring close observation, and the typical conditions clinicians encounter in routine clinical practice are summarized. This article provides an overview of each of the following conditions: congenital anomalies (horseshoe kidneys among other such abnormalities), kidney failure, pyelonephritis, urinary calculi, cystic disease, and neoplastic lesions (angiomyolipoma, renal cell carcinoma).