42-2_26回関東甲信越地方会Pr6N_念*.indd

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1 TFT acoustic radiation force ARALA TI MI TI / MI TI / MI PZT MASON 20 MRayl 20 MRayl khz 20 MHz 1 mw 15 W 500 khz 20 MHz 100 W 60 MHz DNA DNA 10 khz 100 khz DNA DNA DNA DNA

2 PC MRI RI CT A

3 CRP : 2. 2 mg/dl, : 13, 300 L : 891 / L CK : 199 IU/L. ST I, II, avf, V / L mmhg ST 104 mmhg ARVC WHO CT MRI PTA CT MRI MRI CT MRI MRI MRI

4 5 3 CT Marfan annulo aortic ectasia AAE IgG4

5 T Bil 8. 6 mg/dl ALT 1044 IU/L PT 57 HAAb IgM A US B VTQ Vs m/sec CEUS VTQ T Bil Vs VTQ CEUS CT VTQ 1. 4 m/sec HVPG 6 mmhg IPH IPH VTQ IVR IVR C 6 7 B RTO NAFLD Activity Score NAS B 51 F 3 Aplio XG 805AT 8 MHz 375 BT 3. 5 MHz B NAS Precision Imaging Precision Aplio HBV 1 HCV 4 3 PBC 1 Precision 0 4 Precision Precision Precision

6 HCC mm LOGIQ 7, S 8, E 9 GE 9 L ImageJ CA US 86 mm CA U/mL 1 B ROI / 3 P = HCC / P = P HCC S 8 58 mm mm CA U/mL CT CA WBC CRP AST/ALT 68 / 58 S 4 air 61 mm CT S 4 air fluid level HCC NASH E.coli Virtual Touch Tissue Quantification VTTQ Enhanced Liver Fibrosis Panel ELF Score VTTQ Vs m/s 5 7 HA 3 P 3 P Timp ELF Score Vs ELF Score

7 R 2 = F Vs F 0 : 1. 49, F 1 : 1. 14, F 2 : 1. 80, F 3 : 2. 43, F 4 : F 1 / 2, F 1 / 3, F 1 / 4 P F ELF Score F 0 : 9. 3, F 1 : 9. 5, F 2 : 10. 7, F 3 : 10. 7, F 4 : F 1 / 2, F 1 / 4 P VTTQ, ELF Score NASH S Map S Map NAFLD 22 GE LOGIQ E9 C 1 6 S Map 5 7 FS ROC S MAP FS 0 3 VS 4 strain index 4 P FS 4 AUC cutoff NASH S Map strain index mm 8 MHz 6 m 250 MHz NASH 1 VTQ 10 m NASH S 5 19 mm Sonazoid Kupffer defect CT wash out EOB MRI PEC S 5 10 cm CT MRI HCC CEUS washout 10 CEUS CEUS S 7 59 mm echo low high halo

8 CT CT US S 6 CT S 6 18 mm MRI T1w low intensity T2w high iso intensity CEUS 22 defect 2 Marginal zone B cell lymphoma MALT type 1 2 CEUS SLE RA US 5 cm hy pervascular defect B DLBCL a CT S mm MRI T1w low intensity T2w high intensity EOB MRI B CEUS poorly diff. adeno ca. pt2 CEUS RFA ehccadhcc RFA 1 ehcc 48 adhcc 143 ehcc RFA Ablative margin AM 3 mm 3 mm ehcc mm RFA adhcc mm RFA / 143 RFA ehcc p= logrank 3 mm AM p = logrank ehcc AM adhcc AM 3 mm low MI high MI GE LOGIQ low MI PI high MI CHA 10

9 low MI high MI db SD db SD db SD db SD 11 1 low MI high MI B S mm 12 4 mm 70 HCV + JCS / 60 AST 4691 ALT 2236 LDH 2819 PT 66 US B CEUS S US B B CT CEUS 3 b CEUS CT CEUS CT MPR VRI CEUS US 1 81 WBC DCM 2 WBC CRP US US AM US US AM 60 CT US Sonazoid CEUS AM

10 AM TACE CT TACE CT TACE HCC TACE TACE CT TACE HCC P 8 P IPNB mm mm IPNB CT MRCP AST 58 U/L ALT 62 U/L ALP 770 U/L GGT 705 U/L T Bil mg/dl HBs HCV CEA 0. 9 ng/ml CA U/mL PSC CT MRCP PSC CT 38 9 mm strong echo 22 mm sonolucentlayer acoustic shadow CT air density ERCP 25

11 VTR 8 8 ALTACLASSE 60 inch SYNAPSE Viewer PACS Viewer GE V scan Dual Probe valsalva Bentall PCI 3 AR 5 AR Dd/Ds 58 / 53 mm, EF 22 moderate AS peak velocity 3. 4 m/s, mean PG mmhg, AVA 0. 9 cm2

12 Low flow Low gradient AS 20 g/kg/min Stroke Volume 44peak velocity 3. 9 m/s, mean PG mmhg, pro jected AVA 1. 1 cm2 8 Dd/Ds 49 / 33 mm, EF p = p= ml p=0. 03 CT MRI B Flow mm 3 1 LOGIQ E 9, S 8 GE B Flow B B Flow B Flow US 30 mm US PET CT Langhans PCR US TACE mm CT beak sign CT beak sign

13 beak sign NET US 13 mm US S 6 15 mm MRI US 2 US 16 mm B NET 14 NET G 2 G groove mm 27 mm 29 mm Vater 3 B U/L AST 190 U/L ALT 73 U/L CT mm US debris CT MRI/MRCP ERCP debris 10 mm ERCP IDUS adenocarcinoma 7 9 x 9 mm pt2pn1m0 Stage 2B EUS Tei index UV flow volume TTTS twin to twin transfusion syndrome TAFD twin amniotic fluid discor dance MD LVRV Tei index UV flow volume donor recipient 2 TTTS 6 7 Tei index TTTS TTTS UV flow volume donor vs ml/min/kg, p=0. 13 ; recipient vs ml/min/kg, p=0. 06 UV flow volume 50 ml/min/kg donor 2 2 IUFD Tei index UV flow volume TTTS UV flow volume IUFD

14 TSH TRAb TRAb g KI 37 KI 2200 g 1 4 Placental lake PL Breus mole BM g PL g BM BM PL SIEMENS ACUSON Freestyle NT RCC AML hump hump RCC 50 CT MRI 1 AML 50 hump hump hump RCC hump AML AML hump mm B mode mm

15 mm 22 mm US Vater hypoechoic cortical rim 60 IgG4 sil2r IgG4 3 4 mm hypoechoic cortical rim US hyperechoic lesion B MALT Mucosa Associated Lymphoid Tissue MALT 7 8 MALT MALT X CRP

16 CT Adenomatoid Adenomatoid 33 4 US mm CKAE 1 / AE 3 D 2 40 Calretinin Adenomatoid mm Adenomatoid PRF 4 B B PRF Fusion Triad Tissue Harmonic Imaging HIFU: High Intensity Focused Ultrasound HIFU PIV Particle Image Velocimetry B

17 Noblus Aplio ml Zenker 60 I i PTH pg/ml mg/ dl Ca mg/dl 8. 5 x x 7. 1 mm Zenker MRI

18 inflammatory myofibroblastic tumor IMT cm 2 8 CT 1. 7 cm 2 9 IMT IMT IMT cm 0 c tubularadenocarcinoma tub 1 Ul + US US 1. 2 cm SM 3 CT ct1bn0m0 stage A Well different tubular adeno carcinoma, pt1b SM 3 N0M0 stage A US mm inflammatory fibroid polyp 2 20 mm gangliocyticparaganglioma cm cm cm cm

19 CRP WBC 3 3 Campylobacter je juni Campylobacter S 62 S tub2 pt3 pn0 stage II 11 CEA PET/CT FDG cm tub2 tub2 pt3 pn0 S C 0 7 C C C 3 60 C 3 15 C 4 24 C 4 17 C 3 60 G 4 56 C C 3 15 C 14 B 1 C G 12 C C 4 14 C G US HCC 50 US S 3 30 mm mosaic pattern HCC US B 10 CT MRI Gd EOB DTPA S 3 HCC 35 mm X 5 40 mm CT X 1 7

20 X 3 CT 3 cm CD8 CD CT MRI SPN 101 mm US US 6 cm CT IgG4 hyaline vascular type No CT ACE CD4 T / CD8 T No VSD X CTR cm 63 kg / / 120 / PVC WBC CRP 4. 5 VSD VSD VSD 3

21 MRI mm TEE CT stalk cm 41 mmhg FDG PET 1 cm MELAS BNP pg/ml DNA AR AR sellers / / SpO L Erb Levine 4 Austin Flint Levine 3 V 4 V 6 avf T 3 T bpm 4 1 E/A 2. 2 E DT 136 ms F 240 bpm CARTO mapping common type E/A 0. 6 DT 214 ms

22 or QOL mg/ 300 mg/ CT MRI 5 POD 3 mg/ QOL

084_41-1_23四国CS6_念*.indd

084_41-1_23四国CS6_念*.indd 2013 10 5 The forgotten chamber.,,,.1.2,,, 3,,. 4,CT,MRI,,,,,,,, fractional area change: FAC,,M tricuspid annular plane systolic excursion: TAPSE TAPSE < 16 mm., s, speckle tracking, Tei index,,,.,,,.,6,.,,,,,