橋本 千樹, 廣岡 芳樹, 川部 直人, 中岡 和徳, 吉岡 健太郎

Senju HASHIMOTO, Yoshiki HIROOKA, Naoto KAWABE, Kazunori NAKAOKA, Kentaro YOSHIOKA

藤田医科大学医学部消化器内科学

Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University School of Medicine

キーワード : pancreatic cystic lesion, transabdominal ultrasonography, tissue harmonic imaging (THI), contrastenhanced ultrasonography (CEUS)

膵嚢胞性病変（pancreatic cystic lesions: PCL）は，近年の腹部画像技術の進歩により偶発的に発見される頻度が増加してきている．PCLには，様々な病態が含まれており，その範囲は良性疾患から悪性腫瘍にまで及ぶ．そのため，最善の治療計画を決定するためには，正確な診断が重要となる．経腹壁超音波検査（ultrasonography: US）は非侵襲的かつ安価なため，広く用いられているため，PCLなどの腹部疾患における初回検査や経過観察の検査にもっとも適切な画像検査だと考えられている．PCL診断におけるUSの可能性と限界，ならびにUSの技術的進歩，PCLにおける超音波所見の特徴について論評する．

Pancreatic cystic lesions (PCLs) are incidental findings that are being increasingly identified because of recent advancements in abdominal imaging technologies. PCLs include different entities, with each of them having a peculiar biological behavior, and they range from benign to premalignant or malignant neoplasms. Therefore, accurate diagnosis is important to determine the best treatment strategy. As transabdominal ultrasonography (US) is noninvasive, inexpensive, and widely available, it is considered to be the most appropriate imaging modality for the initial evaluation of abdominal diseases, including PCLs, and for follow-up assessment. We present a review of the possibilities and limits of US in the diagnosis of PCLs, the technical development of US, and the ultrasonographic characteristics of PCLs.