腎腫瘤性病変の診断における造影超音波検査の有用性

Abstract

腎腫瘤性病変8例を対象に, 新しい超音波造影剤(Levovist)を使用し, 造影超音波検査を施行し有用性を検討した.その結果, 通常のカラードプラ法に比べ腫瘤血流が明瞭に診断され, 診断能の向上を認めた.腎細胞癌の造影超音波検査は, 腎実質及び腫瘍のエコーシグナルが増強し, 造影効果を認めた.形態学的に特徴のある嚢胞型腎細胞癌では, 通常の場合は確認が不充分だが, Levovistを使用した場合は全例確認できた.又, 腎盂癌の造影超音波検査では造影効果は認めなかったが, 腎実質側はカラーシグナルの増強を認め, 腫瘍の血流動態が鮮明になり血流分布を把握できた

We evaluated the efficacy of contrast-enhanced color Doppler ultrasonography with a galactose-based echo contrast agent, Levovist, for the diagnosis of renal mass lesions. The final pathologic diagnosis of eight renal mass lesions was renal cell carcinoma in 6 patients, transitional cell carcinoma in 1 patient and renal cyst in 1 patient (age range, 47 to 77 years; mean, 59.1). Especially in patients with renal cell carcinoma, contrast-enhanced color Doppler ultrasonography showed enhancement of mass lesion blood flow signal intensities. In all patients, contrast enhancement was demonstrated. Diagnostic capacity was improved in all patients, excluding 2 in whom mass lesion blood flow was detected by plain color Doppler ultrasonography. Furthermore, in patients with transitional cell carcinoma, the hemodynamics of mass lesions could be visualized, and diagnostic capacity was high. Contrast-enhanced color Doppler ultrasonography with Levovist, showed markedly higher mass lesion blood flow than that obtained by the plain color Doppler procedure, improving diagnostic capacity. This procedure was useful for diagnosing renal mass lesions.