造影超音波ガイド下の穿刺治療

category:要旨
2016.04.27

造影超音波ガイド下の穿刺治療

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
沼田和司、二本松宏美、羽尾義輝、道端信貴、福田浩之、近藤正晃、
原 浩二、中馬 誠、前田 愼、田中克明

 GE LOGIQ E9 新規convex probeによるnative tissue harmonic imagingのB-modeを低音圧(MI0.27前後)にするとframe rate 30前後で動脈相で腫瘍血管、腫瘍濃染像の観察と穿刺が容易となる。造影EOBMRIもしくは造影CTと上記の造影超音波との融合画像では、B-modeでは同定不可能もしくは境界不明瞭な多血性肝細胞癌を造影超音波動脈相をガイドとして腫瘍濃染部位を穿刺しラジオ波治療が可能。
 Native tissue harmonic imaging obtained as conventional US images combined with the newly developed transducer, which consists of wide-band phase-inversion harmonic gray-scale imaging and software for decreased speckles, provide a high spatial resolution and deep penetration with high frame rates (28-30 frames per second). Using contrast enhanced US based on this native tissue harmonic imaging at a low MI (0.28) and a high frame rate, tumor vessels and tumor stains can be evaluated in detail and in real time. Under the guidance of fusion imaging combining arterial phase contrast-enhanced US using this software and arterial phase contrast-enhanced CT or hepatobiliary phase contrast-enhanced MRI with Gd-EOB-DTPA, we can puncture hypervascular HCC lesions not detectable using conventional US.

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