転移性膵腫瘍の体外式超音波所見の検討

Yutaka Sasaki; 笹木優賢; Takuya Ishikawa; 石川卓哉; Eizaburo Ohno; 大野栄三郎; Hiroki Kawashima; 川嶋啓揮

doi:10.11272/jss.381

転移性膵腫瘍の体外式超音波所見の検討Transabdominal Ultrasound Findings of Pancreatic Metastatic Tumors

笹木優賢¹^,*1，石川卓哉²，大野栄三郎²，川嶋啓揮²Yutaka Sasaki¹^,*1, Takuya Ishikawa², Eizaburo Ohno², Hiroki Kawashima²

¹ 名古屋大学医学部附属病院医療技術部臨床検査部門Department of Medical Technique, Nagoya University Hospital

² 名古屋大学大学院医学系研究科消化器内科学Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine

^*1

［筆頭著者現連絡先］：藤田医科大学病院臨床検査部超音波センター　〒470–1192 愛知県豊明市沓掛町田楽ヶ窪1–98

受付日：2022年3月17日Received: March 17, 2022

受理日：2022年12月15日Accepted: December 15, 2022

発行日：2023年4月1日Published: April 1, 2023

目的：体外式超音波検査における転移性膵腫瘍の特徴的な所見について，明らかにすること．

対象と方法：超音波検査施行後，病理組織所見で転移性膵腫瘍と診断された32例．超音波所見について全例および原発巣別に後方視的に検討を行った．

結果と考察：描出可能であった27例から得られた超音波所見としては輪郭が整と粗造を合わせ明瞭であったものが22例（81%），腫瘤内部均一が23例（85%），腫瘤内部低輝度が18例（67%）の症例で認めた．辺縁低エコー帯，腫瘤内囊胞成分，腫瘤内血流，腫瘤内高エコースポットは半数程度で認めたが，これらは他の膵充実性病変の特徴と類似しており，これだけでは鑑別が困難と考えられる．一方，腎細胞癌転移症例（12例）に限定すると，辺縁低エコー帯を11例（92%），腫瘤内部血流シグナルを10例（83%）と高頻度で認めており，これらの所見は腎細胞癌転移症例に特徴的な所見と考えられた．

結論：転移性膵腫瘍全例での検討では原発巣が様々で，症例数も少なく，特異的な所見の特定は困難であった．しかし，腎細胞癌転移例では辺縁低エコー帯と腫瘤内血流シグナルが高頻度で認められ，特徴的な所見と考えられた．

Purpose: We aimed to study the characteristic findings of pancreatic metastatic tumors on transabdominal ultrasound images.

Subjects and Methods: We reviewed 32 patients who underwent transabdominal ultrasound and were histologically diagnosed with pancreatic metastatic tumor. The ultrasound findings were retrospectively analyzed. Differences in ultrasound findings according to the primary site were also reviewed.

Results and Discussion: Major ultrasound findings from the 27 cases that could be visualized were as follows: clear and smooth or rough contour in 22 cases (81%), homogenous in 23 cases (85%), and hypoechoic echotexture in 18 cases (67%). Marginal hypoechoic zone, cystic component, blood flow signal, and hyperechoic spots were found in approximately half of the tumors, but are also seen in other pancreatic solid tumors, making it challenging to distinguish between them. In contrast, in cases of renal cell carcinoma (12 cases), marginal hypoechoic zone and blood flow signal were frequently observed [in 11 cases (92%) and 10 cases (83%), respectively].

Conclusion: In this study, it was challenging to identify specific ultrasound findings of pancreatic metastatic tumors because of the variety of primary sites and small number of cases. However, intratumoral blood flow signal and marginal hypoechoic zone were commonly seen and were thought to be distinctive findings in cases of renal cell carcinoma.

Key words: transabdominal ultrasound; pancreatic metastatic tumors; marginal hypoechoic zone; intratumoral blood flow signal

超音波検査技術

研究Research Paper

転移性膵腫瘍の体外式超音波所見の検討Transabdominal Ultrasound Findings of Pancreatic Metastatic Tumors