抄録37-2関西36_責.indd
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- かねろう こうじょう
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1 D-1 36-D-2 / 36-D-3 Heart failure with preserved EF : HF-PEF EF S : 255 EF 45% HF-PEF n=45efs 50mm n=2551mm n=20 : EF S S : 7.0±1.1 vs. 5.3± 1.3 cm/s, p<0.05;ef: 59±8 vs. 54±10 %, ns; : 9.4±1.7 vs. 9.2± 1.6 mm, ns EF S :EF HF-PEF S 36-D-4 PCI HG 2D HG PCI 6 PCI 1 HG 108 SsysPCI HG Ssys 15.4%vs17.6% 20.1%vs19.8%PCI %vs19.8%, 20.9%vs21.2%HG 36-D-5 13 AS 13 N T-4-vel 6 2D T-6-strain QRS AS T-4-vel T-6-strain N 36-D-6 2D diastolic stunning 3D 36-D-7 ARDS 1 IE IE 71 ARDS CRP IE IE 3 36-D-8 3D 3DTTE 72 TTE
2 3DTTE TTE TEE 3DTEE 3DTTE 3DTTE 36-D C CRP24.3 MRI 36-D-10 Radial scar 2 radial scar radial scar distortion ACE 0.7cm radial scar 2 60 spiculation AC 2.6cm radial scar 36-D-11 SLN US US SLN 161 US Retrospective SLN US LN47 31 US 5 9 LN 17 LN LN LN 50% LN 3/44 7% 11/17 65% 36-D D13 Sonazoid AGML AST31U/lALT31U/l γ-gtp100u/lt-bil1.8mg/dlwbc5380μl 17.1 /μl CRP0.05mg/dlChild-Pugh AAFP5.2 ng/mlpivka-ii 54mAU/ mlcea0.8ng/mlsonazoid 12 MRISPIO CTDSACTAPCTHA
3 36-D14 Sonazoid 82 B CHBV CT AFP 3, PIVKA-II 37, CEA 5.1, CA Dynamic CT EOB MRI lowt1/t2 low/high CT Sonazoid wash out HCC 36-D15 Sonazoid US S4/8 15mm CTHA CTAP Sonazoid vascular image kupper image 278 US S4 14mm EOB- MRI kupper image GIST 379 US S5 13mm dynamic CT kupper image 36-D16 Sonazoid B option MRI B B B B 36-D17 Fundamental B mode Fundamental B mode Sonazoid Fundamental B mode 30mm 15mm MRI CT US B Fundamental B mode 36-D18 Sonazoid USSPIO MRIEOB MRI Sonazoid Kupffer phasespio MRI Kupffer Gd-EOB-DTPA EOB MRI 27 Sonazoid USKupffer phase Sonazoid 30 EOB MRI 27 Sonazoid US 18 SPIO MRI 16 EOB-MRI % Sonazoid US % defect SPIO MRI % Kupffer EOB 36-D19 US RFA US RFA
4 3cm RFA US 32 LOGIC 7GE, CPImode, MI0.2Sonazoid 0.01ml/ kg 7 RFA 66.5% 5mm margin RFA 36-1 Sonazoid EOB-MRI FNH FNHCT Sonazoid EOB-MRI FNH 68 CT S8 S8 low echoic nodule Sonazoid Vascular phase Kupffer phase EOB-MRI T1T2 FNH Sonazoid Kupffer FNH EOB-MRI 36-2 Sonazoid 51 US SOL HBs HCV AFPPIVKAII S32.2cm dynamic CT EOB MRI B US Aplio50 Sonazoid US 2 Kupffer US 36-3 CREST 70 CREST follow H20 9 2cm SOL GFS, CFS CT MRI H21 6 CREST CREST 36-4 Sonazoid LS Sonazoid Kupffer L/S 45 C 10 /μl A /μl B 34 AplioXG Sonazoid ml/Kg 20 L/S L/S 0.68A -0.85B B A A L/S 36-5 Sonazoid Kupffer low MI high MI HCC Sonazoid Kupffer low MI high MI HCC
5 Aplirio XG low MI 2-4%10-15fps highmi 100%2fps B mode Sonazoid ml/kg Kupffer low MI ADF B mode mosaic 6 Kupffer Low MI iso 12 high MI 8 B 7 1 HCC low MI high MI 36-6 Sonazoid 1 66 EOB MRI S3 2cm S4 1cm CT B Sonazoid Kuppfer image Sonazoid XarioXG B Sonazoid Kuppfer image S3S4 low echoic legion Sonazoid 36-7 Sonazoid C MRI S8 6cm GdEOB MRI Sonazoid Micro Flow Imaging FNH CT MRI FNH Sonazoid MFI FNH FNH 36-8 B C Sonazoid B C Sonazoid 81 HT(+)DM(-)HCV(-)HBs-Ag(-) CT HCC CLD FL(-)5-10mm defect(-) defect(+) 1 (+) defect(+) defect(+) B C Sonazoid 36-9 Sonazoid US HCC 2 RFA Sonazoid US EUB7500 RFA 46 RFA RFA 50 :1, :1 viable lesion 26 2 NBNC HCC 1 45 polyp 09 4 US S7:6mm CT EOB-MRI HCC 5 US RFA Well HCC RFA Sonazoid Sonazoid Sonazoid CEUS 3 152, CEUS ASTALTLDHγ-GTP BUNCRNCRP.
6 CEUS 1/472% 2/922% 1/1001% 1/1001% 3 Sonazoid CEUS NASH MCD Sonazoid MCD ±4.4dB 4 0.5mg -12±4dB, 2.0mg -9.8± 2.8dB P<0.05 MCD NASH B Sonazoid Kupffer Pitavastatin Pitavastatin NASH Acoustic Radiation Force Impulse ARFI 2008 B Acoustic Radiation Force Impulse ARFIARFI ARFI 228 F0 13 F1 63 F2 55 F3 45 F ACUSON S2000 Vs m/s F0 1.17±0.19F1 1.26± 0.23F2 1.42±0.38F3 1.62±0.52F4 2.31±0.65 Vs m/s F3 F4 P <0.001 ARFI Acoustic Radiation Force Impulse ARFI 2008 B Acoustic Radiation Force Impulse ARFI ARFI AFRI ACUSON S2000 Vs m/s 1.21± ± ± ± ± ±0.09 Vs ARFI ARFI ARFI Vs F0~F2 1.0~1.5 F3 1.2~1.7F4 1.7~2.5m/s ARFI % F1 F3 Vs % 3 ALT F3 F4 Vs AHI1 1 1 ARFI VSD
7 Levin V/VI LVd60/44mm EF=50% 13 12mm RCC AR VSD +Bentall AR VSD 1 76 VSD 1 4 UCG VSD 45mmHg VSDLCX 90% UCG 68mmHg VSD VSD VSD VSD CT Qp/Qs Levine III/IV 1 55mm CTA Unroofed coronary sinus unroofed coronary sinus Qp/Qs=1.1 unroofed coronary sinus Bentall,
8 5 Bentall : 1 58 accesory cusp 2 42 accesory cusp 0.008% 0.013% fmr fmr 2 1:59 3 MR MR 2:61 MR MR : 2 1 MR 2 MR UCG Scan Assistant GE Logiq E9 Scan assistant Scan assistant Scan assistant IMT IMT IMT 0.1mm IMT
9 36-27 DVT DVT Maron mmhg β 1.6 m/s ST-T P2P3: CPK 2 IIIIIaVFV4-6 ST base normal~hypermid~apex severe hypokinesis I CT ST-T EF39% FreeT4; 4.1ng/dlTSH; <0.05μIU/ml Sigmoid septum Sigmoid septumss ASA SS ASA SS 110 ASA 15mm 10mm 11mm SS(+) :11 ASA 80%SS(-) ASA 50.9% SS 2 PFO SS ASA ASA SS ASA bpm, 60 TroponinT IABP Forrester IV PCPS
10 5 PCPS 6 IABP CT NYHA III IABP 15 PCPS 18 opening 5cm high echoic PCPS diffuse large B cell lymphoma:dlbcl ECGHR36 US cm sil-2r CTMRI DLBCL 1 US MRI BMIPP Solid-pseudopapillary tumor 1 Solid-pseudopapillary tumorspt 30 US 4cm CT MR US CT MR SPT SPT SPT SPT cm PET-CT 21 5 SMA(+)c-kit(-)CD34(-)S100(-) 10/ mm hypervascular 23 MFI
11 CT MRI T1 low intensity T2 high intensity high intensity PET-CT Vimentin CD34c-kitSMA 44 US mm CT Sonazoid ERCPPET-CT MFI hypervascular hypovascular NASH NAFLD NASH NAFLD27 NASH45 AplioXG Levovist1.25g 5 20 ADF Nemio 5 20 NASH NAFLD p>0.01nas Kupffer NAFLD NASH Biopsy AML AML Resistant Index sweet MRSA 39 S5 35mm CT, USCT US WBC15080μlCRP6.86 /dl
12 Eosino52%IgE1583IU/ml US SMT US 7cm CT 6.5 3cm GIST EUSFNA AMY 3 0 CA19-9,CEA GIST cm cystic part GIST S pseud-kidney sign SMT 4 GIST Gastrointestinal stromal tumor S GIST GIST S GIST 1 60 US S7 5.6cm 3.6cm CT 8mm CT MRI T1WI T2WI Gd-EOB-DTPA Sonazoid US hyperintense hypointensekupffer defect PET-CT FDG 11 GIST GIST GIST 1 59 H20 11 CT 9cm GIST c-kit CD34 α-sma Lemmel Lemmel 67 5 ERCP 3cm : Lenmel
13 Sonazoid 10 GE Logic7E94MHz MHz : / : : 5.8cm/s 2.9cm/s 0.2cm/s 2.4cm/s 1.3cm/s 0.3cm/s : : US Hb10.0g/dl Hb7.5g/dl CT Hb 5.8g/dl 4 19 US Sonazoid US plainus Sonazoid 50 US US Sonazoid US multiple concentric ring sign 17mm strong echo US CT 120cm 15mm 36-54
14 US ERCP ERCP IDUS EST ERCP IDUS ERCP 2 68 ERCP ERCP IDUS IDUS IDUS IgG4 1 IgG4 US IgG 23 IgG4 US 2.6mm 2.6mm IgG4 US Mirizzi Mirizzi mm Mirizzi ERCP Mirizzi Mirizzi CTMREUSERCPIDUS Ib US US Ib S 1
15 S 1 65 CEA 25cm CTMRI 10cm S S Sigmoid colon cancer,fstage III a SiN0H0P0M US 60 S CT US S US CEA CD20cyB cell B US / SpO2 98% US3 4 : mm mm US:S 5cm 4 6cm Doppler US CT: S CZOP mm 2 fluidcollection 2 1 CT 1 fluidcollection 2 1
16 CT C cm 5cm CT cm WBC21730/μlCRP32.48mg/dl 5cm CT 5cm ALS M ALS M ALS Ca:12.2mg/dlintact PTH:430pg/ml 31mm 3 Ca:8.4mg/dl, intact PTH:109pg/ml 40mm Ca x16x21mm class 5 : x23x46mm class x14x16mm SAV
17 GD44 PT22 PT37GD 44 M/FPT 4/18GD 10/34 TSH μu/mlpt 0.005GD FT4 ng/dlpt 2.82GD 4.59FT3 pg/mlpt 8.69GD15.57TRAb U/mlPT 1.0GD 8.2 : mlpt17.2gd 27.4SAV cm/secpt 23.1 GD 55.3SAV GD P<0.0001ROC AUC 0.96 SAV GD PT cm DCT MRI T1 T2 T2 achwannoma HE MCA-PSV E MCA-PSV Hb7.5g/dl MCA-PCV MCA-PSV 34 MCA-PSV Hb 9.6g/dl RhD D 31 D Hb 15.3g/dl 34 MCA-PSV 35 Hb6.9g/dl Hb 7.5g/dl MCA-PSV EUB-7500 EUP-V53W Mann-Whitney U test p< p< p= : 3 24 : 11 : 100% 82%36%18% 89% 82% 44% : T4N1M0 PR 9 CT 3cm hypovascular 34βE12 p63 CK7 CK20TTF-1
18 UN 45.6mg/dl, CRTN 4.94mg/dl, CRP 6.80mg/dl 30mm 10mm UCG : real-time tissue elastography TRTE : 106 PSA IQR ng/ml ng/ml B-mode TRTE : 41 39%TRTE 51% 72% : TRTE TRTE Sonazoid : Sonazoid :Sonazoid 7 Clear cell ca. 4 Cystic RCC1 Papillary RCC 2 GE LOGIQ74C coded phase inversion Sonazoid 0.01ml/ Kg MI 0.2 : Clear cell ca. WEST PPC CAPD 2 PPC CAPD 1.6% US CAPD PPC US PPC CAPD PPC RI PPC US PPC CAPD CAPD HD SEP 3 14 US 1 PPC SEP US PPC CT CT B X 240 X 23G 1,2 X X
19 36-82 : ML SLN :ML SLN : 2007 ML67 46 / :SLN 16.2±6.5mm 11.7±4.7mm6.2±2.3mm 10.7±5.2mm5.1±1.5mm : SLN SLN Sonazoid US 77 CT Sonazoid US B-Flow color Sonazoid US Paget-Schroetter Paget-Schroetter Paget-Schroetter Lab data 5900/μl CRP 0.17mg/dlD-dimer1.4μg/ml Paget-Schroetter Paget-Schroetter stageiv D-dimer 31.9μg/ml IVC 3 CT IVC : :34 MRI MRI MRA 8 MRI MRA C5 1 C5/6 C4/5 : : SCA :79 VA SCA SCA 86% VA VA
20 VA : SCA : :54 MRA 3.8m/sec :
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