Japanese Journal of Medical Ultrasound Technology
Online ISSN : 1881-4514
Print ISSN : 1881-4506
ISSN-L : 1881-4506
Volume 43, Issue 1
Displaying 1-10 of 10 articles from this issue
  • Naoko Maeda, Hiroshi Sakuma, Hiroto Koyama, Fumie Ihara, Hideki Yokono ...
    2018 Volume 43 Issue 1 Pages 13-21
    Published: February 01, 2018
    Released on J-STAGE: April 05, 2018
    JOURNAL FREE ACCESS
  • Yasunori Okuda, Masumi Osugi, Yasuhiro Otuka, Osamu Takaishi, Izumi Mo ...
    2018 Volume 43 Issue 1 Pages 22-33
    Published: February 01, 2018
    Released on J-STAGE: April 05, 2018
    JOURNAL FREE ACCESS

    Purpose: This study was conducted to examine whether there are characteristic findings of hepatic malignant lymphoma on B-mode and Doppler ultrasonography.

    Subjects and Methods: Eleven patients (8 men and 3 women, median age 83 years) who were diagnosed with malignant lymphoma by biopsy or hepatectomy after ultrasonography between January 2011 and December 2015 were analyzed retrospectively. Histologically, there were 8 diffuse large B-cell lymphomas, 1 extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue, 1 methotrexate-associated lymphoproliferative disorder and 1 Hodgkin lymphoma.

    Results and Discussion: There was a significant difference in B-mode findings and Doppler findings between tumors with diameters of ≧30 mm and those with diameters of <30 mm (≧30 mm: 6 cases, <30 mm: 5 cases). Tumors with a diameter of ≧30 mm appeared as hypoechoic masses with heterogeneous internal echo, with linear or dotted hyperechoic images. On color Doppler, penetration of normal vessels was observed inside the tumor. Tumors a diameter of <30 mm appeared as hypoechoic masses with homogeneous internal echo, and displayed images that were not suggestive of vascular penetration. Histopathological characteristics did not correlate with ultrasonographic findings in any of the cases.

    Conclusion: We conclude that the ultrasonographic findings of hepatic malignant lymphoma might vary with a diameter of 30 mm. It was suggested that the ultrasonographic differential diagnosis capability of hepatic malignant lymphomas might be improved by assessing the tumor diameter and the internal echo on B-mode and by evaluating the presence or absence of the vascular penetrating image on color Doppler.

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  • Minoru Kikuchi, Ryo Ohtani, Hiroshi Saito
    2018 Volume 43 Issue 1 Pages 34-42
    Published: February 01, 2018
    Released on J-STAGE: April 05, 2018
    JOURNAL FREE ACCESS

    Purpose: We investigated the clinical significance of blood flow measurements using ultrasonography in the anastomotic distal portion of an arteriovenous fistula (AVF).

    Methods and Materials: The study population comprised 38 hemodialysis patients (right shunt: 3 patients; left shunt: 35 patients) who underwent periodic vascular-access ultrasonography at our hospital between May 2014 and December 2014. Blood flow direction and volume at the anastomotic distal portion were measured. Blood flow direction was determined using the color Doppler technique, and the time-average flow rate was measured using the pulsed-wave Doppler technique. The direction from the distal to the anastomotic portion was defined as Type 1, and the direction from the anastomotic portion to the distal portion was defined as Type 2. Blood flow volume in the two types of brachial arteries and the radial and ulnar arteries was quantitatively compared. In addition, the ratio of blood flow volume in the ulnar to that in the radial arteries (ulnar/radial) was compared. Cases with severe stenosis (<2 mm) of lumen in the vascular access and those with a low brachial arterial blood flow volume (<500 mL/min) were excluded.

    Results: Blood flow directions and volumes in the shunt anastomotic distal portion of the AVF were as follows: Type 1, 65.8% (25 cases) and 126.1±114.9 mL/min, and Type 2, 34.2% (13 cases) and 80.4±57.6 mL/min, respectively. No significant difference was observed between blood flow types, which in flow volume of the brachial artery, the radial artery, and the ulnar artery. The ulnar/radial blood flow volume ratio was significantly different between the two studied types (Type 1: 0.44±0.22; Type 2: 0.29±0.25; p=0.02). Steal syndrome was suspected in two cases.

    Discussion: The hemodynamics of AVF revealed two types, and the blood flow directions were forward and opposite. The blood flow direction appeared to be related to the ulnar/radial blood flow volume ratio. When the blood flow is in the forward direction, in theory, brachial arterial blood flow and shunt blood flow do not have similar values. In this case, it was considered appropriate to evaluate the radial arterial blood flow volume (i.e., brachial arterial blood flow volume subtracted from brachial ulnar arterial blood flow).

    Conclusion: In the present study, the clinical significance of the hemodynamics of the anastomotic distal portion of AVF using vascular-access ultrasonography was not clear. However, we clarified that the blood flow direction in the anastomotic distal portion was related to the ulnar/radial blood flow volume ratio. In addition, we proposed that shunt blood flow estimated from brachial arterial blood flow should be corrected when the blood flow direction of distal anastomosis detected forward blood flow.

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