早期肝癌と境界病変の造影超音波診断
＊1横浜市立大学附属市民総合医療センター消化器病センター、 ＊2湘南藤沢徳洲会病院病理診断科
沼田和司＊1、 二本松宏美＊1、 羽尾義輝＊1、 道端信貴＊1、 福田浩之＊1、近藤正晃＊1、 中馬 誠＊1、 田中克明＊1、 中野雅行＊2
ソナゾイド造影超音波を用い腫瘍血管の走行パターンにおいて腫瘍の辺縁から中心に向かうパターンを
peripheral vessels pattern、腫瘍の中心から末梢に向かうパターンをcentral vessels patternと二分した。
eHCC （n=83）では98％、HGDN （n=6）では100％がperipheral vessels pattern、一方RN （n=13）で
は100％がcentral vessels patternであり、central vessels patternのときRNである感度100％、特異度
97.8％、正診率98％であった。
We performed contrast-enhanced US using a perflubutane based contrast agent. We then classified
the tumor vessels observed during the arterial phase of contrast enhanced US into two patterns:
peripheral vessels (centripetal pattern) and central vessels (centrifugal pattern). Eighty-one (97.6%) of the 83 early HCC exhibited various enhancement patterns and a peripheral vessel pattern, while the remaining 2 lesions (2.4%) exhibited a central vessel pattern. All 6 high grade dysplastic nodule (HGDN)lesions exhibited a peripheral vessel pattern. All 13 regenerative nodule (RN) exhibited a central vessel pattern. When lesions exhibiting a central vessel pattern during arterial-phase contrast-enhanced US were diagnosed as RN, the sensitivity, specificity, and accuracy of these diagnoses were 100%, 97.8%,and 98.0%, respectively.
