臨牀消化器内科 Vol.16 No.1(1)

特集名	膵疾患の画像診断
題名	体外式USにおける膵疾患診断の進歩
発刊年月	2001年 01月
著者	今井英夫	藤田保健衛生大学医学部消化器内科
著者	堀口祐爾	藤田保健衛生大学医学部消化器内科
著者	久保裕史	藤田保健衛生大学医学部消化器内科
著者	鈴木智博	藤田保健衛生大学医学部消化器内科
著者	上松正尚	藤田保健衛生大学医学部消化器内科
著者	竹内文康	藤田保健衛生大学医学部消化器内科
著者	鈴木理恵	藤田保健衛生大学医学部消化器内科
著者	渡辺美帆	藤田保健衛生大学医学部消化器内科
著者	刑部恵介	藤田保健衛生大学医学部消化器内科
著者	西川徹	藤田保健衛生大学病院臨床件さ研究部
【要旨】	膵疾患の診断における超音波検査(US)の位置づけをみると，最近では体外式USはスクリーニング的要素が強く，精密検査法としては超音波内視鏡(EUS)，管腔内超音波(IDUS)などが定着しつつある．しかし，近年の超音波機器の技術革新は目覚ましく，power Doppler法，tissue harmonic imaging法，造影harmonicimaging法などが次々と登場してきている．これらの手法は体外式USのもつ簡便性，リアルタイム性，低侵襲性という特徴を生かしつつ，優れた空間分解能と同時に血流情報を得ることが可能となり，精密検査としても十分診断的意義があるものと思われる．本稿では，これらの手法の有用性につき膵腫瘤性病変を中心に述べた．

Theme	Imaging in Pancreatic Disease
Title	New Horizons in Ultrasonic Imaging of the Pancreas
Author	Hideo Imai	Department of Internal Medicine, Fujita Health University School of Medicine
Author	Yuji Horiguchi	Department of Internal Medicine, Fujita Health University School of Medicine
Author	Hiroshi Kubo	Department of Internal Medicine, Fujita Health University School of Medicine
Author	Tomohiro Suzuki	Department of Internal Medicine, Fujita Health University School of Medicine
Author	Masanao Uematsu	Department of Internal Medicine, Fujita Health University School of Medicine
Author	Fumiyasu Takeuchi	Department of Internal Medicine, Fujita Health University School of Medicine
Author	Rie Suzuki	Department of Internal Medicine, Fujita Health University School of Medicine
Author	Miho Watanabe	Department of Internal Medicine, Fujita Health University School of Medicine
Author	Keisuke Osakabe	Department of Internal Medicine, Fujita Health University School of Medicine
Author	Tooru Nishikawa	Department of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine
[ Summary ]	Recent advances in ultrasonic technology have led us to the next stage in diagnosing pancreatic diseases. In this paper, we present the benefits of tissue harmonic imaging(THI), power Doppler imaging(PDI) and contrast harmonic imaging using Levovist. We examined 232 patients with pancreatic cancer from 1979 to 2000, using B-mode ultrasonography(US). With development of US technology, tumor observation has improved. THI technology has offered especially clear observations of tumors even in a case where the cancer was classified as T1 size(2cm or less in diameter). On the other hand, PDI can delineate extra- and intra-pancreatic vessels, in most cases. In advanced cases of pancreatic cancer, arterial invasion could be assessed at 82%, and portal invasion at 86%. In conclusion, THI and PDI seem to offer a potential for easy differentiation of pancreatic mass and non invasive assessment of tumor extension.

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