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An anomaly in persistent right umbilical vein of portal vein diagnosed by ultrasonography

World Journal of Gastroenterology 2005年第8期11卷 1179-1181页

作者： shigeo nakanishi Katsuya Shiraki Kouji Yamamoto Mutsumi Koyama Takeshi Nakano First Department of Internal Medicine Matsusaka Central General Hospital of Medicine

AIM: To detect the anomaly in the persistent right umbilical vein (PRUV) of portal vein (PV) with deviation of the ligamentum tere and left-sided gallbladder.METHODS: A total of 5783 candidates for routine analysis were evaluated for hepatic vascular abnormalities by ultrasonography.RESULTS: Ten candidates (0.17%) had a portal vein anomaly with a rightward-deviated ligamentum tere.The blood-flow velocity in the PRUV of the portal vein (17.7±3.0 cm/s) of the 10 cases was similar to that of the right anterior portal trunk (17.6±4.1 cm/s). However,the vessel diameter of the PRUV (ψ12.4±4.4 mm) was larger than the right anterior portal trunk (ψ6.1±0.9 mm).Therefore, flow volume in the anomalous portion (0.97±0.30 L/min) was more than that in the right anterior portal trunk (0.18±0.05 L/min).CONCLUSION: The anomaly plays an important role in intra-hepatic PV flow.

关键词：脐带血管超声检查肝门静脉胆囊韧带

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Hemodynamics in the portal vein evaluated by pulse wave Doppler ultrasonography in patients with chronic hepatitis C treated with interferon

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World Journal of Gastroenterology 2005年第3期11卷 396-399页

作者： shigeo nakanishi Katsuya Shiraki Kouji Yamamoto Mutsumi Koyama Noboru Kimura Takeshi Nakano First Department of Internal Medicine Toshiba Corporation

AIM: To employ pulse wave Doppler ultrasonography to evaluate the changes in portal blood flow velocity in patients with chronic hepatitis C (CHC) receiving interferon (IFN)treatment.METHODS: The subjects in this study were 14 patients (13 men and 1 woman) with CHC who received IFN treatment. Portal blood flow velocity was measured in the vessels at the porta hepatis at four time points: before IFN administration (pre-IFN), 2 wk after the start of administration (wk 2), 24 wk after the start of administration (wk 24, i.e.,the end of IFN administration), and 24 wk after the end of administration (wk 48).RESULTS: The patients with CHC in whom IFN treatment resulted in complete elimination or effective elimination of viruses showed a significant increase in portal blood flow velocity at the end of IFN treatment compared with that before IFN treatment. In contrast, when IFN was ineffective, no significant increase in portal bloocl flow velocity was observed at wk 24 or 48 compared with the pre-IFN value. In addition,the patients with CHC in whom IFN was ineffective showed significantly lower portal blood flow velocity values than control subjects at all measurement time points.CONCLUSION: Pulse wave Doppler ultrasonography is a noninvasive and easily performed method for evaluating the effects of IFN treatment in patients with CHC. This technique is useful for measuring portal blood flow velocity before and 24 wk after IFN administration in order to evaluate the changes over time, thus assessing the effectiveness of IFN treatment.

关键词：血流动力学血管入口脉搏多普勒超生诊断法慢性丙型肝炎干扰素 CHC

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1.5 Harmonic Imaging Sonography with microbubble contrast agent improves characterization of hepatocellular carcinoma

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World Journal of Gastroenterology 2005年第36期11卷 5607-5613页

作者： Kouji Yamamoto Katsuya Shiraki shigeo nakanishi Hiroyuki Fuke Takeshi Nakano Akira Hashimoto Atsuya Shimizu Toshinobu Hamataki First Department of Internal Medicine Mie University School of Medicine Tsu Mie 514-8507 Japan Department of Internal Medicine Saiseikai Matsusaka General Hospital Matsusaka Mie 515-8557 Japan Sales Engineering Department Toshiba Medical Systems Corporation Nagoya Aichi 450-0003 Japan

AIM: To investigate the usefulness of 1.5 Harmonic Imaging Sonography with the use of the contrast agent Levovist for the diagnosis of hepatocellular carcinoma (HCC) and for the evaluation of therapeutic response.METHODS: Phantom experiments were performed to compare the contrast effects of 2nd harmonic imaging and 1.5 Harmonic Imaging Sonography. 1.5 Harmonic Imaging Sonography was employed to examine 36 patients with HCC (42 nodules) before and after the treatment and to compare against the findings obtained using other diagnostic imaging modalities. RESULTS: In 1.5 Harmonic Imaging Sonography, the tumor vessels of HCCs were clearly identified during the early phase, and late-phase images clearly demonstrated the differences in contrast enhancement between the tumor and surrounding hepatic parenchyma. Blood flow within the tumor was detected in 36 nodules (85.7%)during the early phase and in all 42 nodules (100%) during the late phase using 1.5 Harmonic Imaging Sonography,in 38 nodules (90.5%) using contrast-enhanced CT, in 34nodules (81.0%) using digital subtraction angiography (DSA), and in 42 nodules (100%) using US CO2angiography.Following transcatheter arterial embolization, 1.5Harmonic Imaging Sonography detected blood flow and contrast enhancement within the tumors that were judged to contain viable tissue in 20 of 42 nodules (47.6%).However, 6 of these 20 cases were not judged in contrastenhanced CT. 1.5 Harmonic Imaging Sonography was compared with the US CO2 angiography findings as the gold standard, and the sensitivity and specificity of these images for discerning viable and nonviable HCC after transcatheter arterial embolization were 100% and 100%,respectively.CONCLUSION: 1.5 Harmonic Imaging Sonography permits the vascular structures of HCCs to be identified and blood flow within the tumor to be clearly demonstrated.Furthermore, 1.5 Harmonic Imaging Sonography is potentially useful for evaluating the therapeutic effects of transcatheter arterial embolization on HCC.

关键词： 1.5谐波成像超声检查肝细胞癌临床表现

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Basket pattern blood flow signals discovered in a case of splenic hamartoma by power Doppler ultrasonography

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World Journal of Gastroenterology 2005年第33期11卷 5235-5238页

作者： shigeo nakanishi Katsuya Shiraki Kouji Yamamoto Takeshi Nakano Mutsumi Koyama Takatsugu Yano Takayuki Sanda Hisao Tamaki Tadanori Hirano Kazuo Fukudome Akinori Ishihara First Department of Internal Medicine Mie University School of Medicine Tsu Mie 514-8507 Japan Department of Internal Medicine Matsusaka General Hospital Matsusaka Mie 102 Japan First Department of Internal Medicine Mie University School of Medicine TsuMie 514-8507Japan Department of Internal Medicine Matsusaka General Hospital Matsusaka Mie 102 Japan Department of Surgery Matsusaka General Hospital Matsusaka Mie 102 Japan Tadanori Hirano Department of Radiology Matsusaka General Hospital Matsusaka Mie 102 Japan First Department of Internal Medicine Mie University School of Medicine Tsu Mie 514-8507 Japan Department of Pathology Matsusaka General Hospital Matsusaka Mie 102 Japan

We present the gray-scale ultrasonography (GSUS), power Doppler ultrasonography (PDUS), abdominal computed tomography (CT), and magnetic resonance imaging (MRI) findings for a case of splenic hamartoma in a 27-year-old man, showing a ψ 50 mm homogeneous, iso- and hypo-echoic splenic mass with evidence of a small plural cystic lesion.This splenic hamartoma showed increased vascularity on power Doppler sonograms. PDUS showed multiple circular blood flow signals inside the mass (i.e. a basket pattern),which was consistent with the small plural cystic lesion shown by GSUS. Spectral analysis also confirmed arterial and venous flow. CT scans showed that the mass had lowdensity relative to the normal spleen and MRI showed that the mass was isodense, relative to the normal spleen.Therefore, CT and MRI are not useful for the diagnosis of splenic hamartoma. Ultrasonography can be used to diagnose splenic hamartoma without administration of a contrast material and therefore is an indispensable method for the diagnosis of splenic hamartoma.

关键词：血液流动信号脾脏错构瘤多普勒超声波检查 CT检查 MRI检查

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