원발성 간암에 대한 초음파적 고찰

Abstract

[한글]

초음파검사의 기술적인 면이 개선됨에 따라, 정적영상(Staticimaging) 및 B-mode scanner에 digital computer system으로 조직에 관한 실질 및 종양에 패한 grading이 가능하게 초음파 진단에 의해서 방사선의 피해없이, 비관혈적으로 시행할수 있고, 간실질내의 병변의 성질을 보다 쉽게 구별할수 있게 되었다.

동위원소를 이용한 간 주사 및 혈관조영술과 더불어, 원발성간암의 진단에 초음파를 이용함으로써, 진단의 정확도를 높일 수있고, 병변의 진행과정 및 치료후의 추적검사가 보다 용이해졌다. 이에 저자는 1980년 5월 1일부터 1981년 8월 31일까지 원발성간암으로 확진된 30예의 환자의 초음파적 소견을 분석하여 다음과 같은 결과를 얻었다.

1. 원발성 간암의 초음파검사소견은 discrete echofree, discrete echogenic, ill defined echogenic, mixed pattern의 4가지 형으로 분류할 수 있었으며, 가장 많은 형은 discrete echogenic한 형태로 30예중 17예 (57%)였으며, 다음이 ill defined echogenic한 형태로 7예(23%)였다.

2. 초음파검사상 측정한 원발성간암의 크기는 30예중 28예가 5㎝이상이였으며, 2예에서만 5cm이하로 나타났다.

3. 혈관조영술을 시행한 7예에서 원발성간암의 echogenicity와 혈관조영술에서 보인 혈관분포의 양상이 일치됨을 보였다.

4. 초음파소견상 echogenic한 양상을 나타낸 원발성간암에 있어서, 간경변증과의 동반율이 높은 것 같았다.

Ultrasound Manifestation of Hepatocellular Carcinoma

Mi Soo Hwang

Department of Medical Science The Graduate School, Yonsei University

(Directed by Professor Chang Yun Park, M.D.)

With the advent of grayscale sonographic equipment, the parenchymal disease of

liver is more easily evaluated. Ultrasonography is a non-invasive technique,

different from angiography, and performed without patient's discomfort And also

ultrasonography can be used in assessing the liver in cases showing equivocal

scintigraphy and in differentiation of solid and cystic masses, first detected on

scintigrams. Therfore, the complementary use of ultrasonography, Tc-99m-sulfur

colloid scan and angiography provides better diagnostic accuracy for the detection

of hepatocellular carcinoma, and moreover, sequential ultrasonographic studies in

the same patient are valuable of following the course of hepatocellular carcinoma

and monitoring the effectiveness of therapy for hepatocellular carcinoma.

In thirty patients with histologically proven hepatocellular carcinoma, an

analysis of ultrasound manifestations is made, and the results are as follows;

1. Ultrasound manifestation of hepatocellular carcinoma by gray scale showed four

different sonographic patterns including discrete echofree, discrete echogenic, ill

defined echogenic and mixed patterns.

The most common sonographic pattern was discrete echogenicmass (57%).

2. The size of hepatocellular carcinoma by ultrasonographic measurement was.

larger than 5 cm in diameter in 28 cases.

3. In 7 cases performed with angiography, all echogenicities of hepatocellular

carcinoma were correlated with the findings of vascularity of angiography.

4. In cases combined with liver, cirrhosis, the sonographic pattern of

hepatocellular carcinoma appeared to be discrete echogenic and ill defined

echogenic patterns.

[영문]

With the advent of grayscale sonographic equipment, the parenchymal disease of liver is more easily evaluated. Ultrasonography is a non-invasive technique, different from angiography, and performed without patient's discomfort And also

ultrasonography can be used in assessing the liver in cases showing equivocal scintigraphy and in differentiation of solid and cystic masses, first detected on scintigrams. Therfore, the complementary use of ultrasonography, Tc-99m-sulfur colloid scan and angiography provides better diagnostic accuracy for the detection of hepatocellular carcinoma, and moreover, sequential ultrasonographic studies in the same patient are valuable of following the course of hepatocellular carcinoma and monitoring the effectiveness of therapy for hepatocellular carcinoma.

In thirty patients with histologically proven hepatocellular carcinoma, an analysis of ultrasound manifestations is made, and the results are as follows;

1. Ultrasound manifestation of hepatocellular carcinoma by gray scale showed four different sonographic patterns including discrete echofree, discrete echogenic, ill defined echogenic and mixed patterns.

The most common sonographic pattern was discrete echogenicmass (57%).

2. The size of hepatocellular carcinoma by ultrasonographic measurement was. larger than 5 cm in diameter in 28 cases.

3. In 7 cases performed with angiography, all echogenicities of hepatocellular carcinoma were correlated with the findings of vascularity of angiography.

4. In cases combined with liver, cirrhosis, the sonographic pattern of hepatocellular carcinoma appeared to be discrete echogenic and ill defined echogenic patterns.