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		<h1 class="catchCopy">助産師も！学び直しの医師も！基礎を学んで超音波診断装置を使いこなす！</h1>
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		<h1 class="title">もっときれいに撮れる！産科・婦人科超音波検査<span class="version"></span></h1>
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">やさしく原理に触れながら，装置使用の実際をボタン１つから懇切丁寧に解説．細かい操作手順と実際のエコー画像の比較で仕上がりの違いがよくわかる．アーチファクトもなぜ出るかが分かれば，すぐに対処可能！ありがちなトラブルには「こんなときどうする？」でお悩み解決．多数の著作で定評のあるDr.Babaのレクチャーを受ければ，あなたの超音波画像が，明日から変わります！</section><section class="preface">■序文<br><br>　超音波断層像を動画としてリアルタイムに表示する超音波診断装置が産婦人科に導入されるようになった1970年代後半は，大学病院のごく一部の産婦人科医が超音波検査を行っていた．当時の画質は粗く，大半の産婦人科医にとって表示される画像はわかりにくく，日常診療というより研究目的で使われることが多かった．<br>　それから半世紀が経ち，超音波診断装置はすべての産婦人科医が日常臨床で当たり前のように使用し，さらに助産師，臨床検査技師，診療放射線技師など多くの人が検査を行うようになった．装置は格段の進歩を遂げ，超音波診断装置の基礎的な知識がそれほどなくてもプローブを当てればそれなりの画像が得られるため，すぐに検査は行える．しかし，知識不足などから必要な画像が得られない，画像が不鮮明で診断に適さない，使いかたが不適切で正確な診断ができていないなどの問題がある．<br>　本書では，これから超音波検査を始めようとする方，既に超音波検査を行っているが自らの技術を向上させたいと思っている方々を対象に，超音波診断装置を使うための基礎から，より適切に使用する方法，ピットホール，より高度な使いかたをするためのヒントなどを，豆知識やこんなときどうしたらいいか，なども含めてまとめた．<br>　産婦人科の超音波検査では断面を見る断層法が中心であるが，血流を見て評価するカラードプラ法やパルスドプラ法，胎児を立体的に表示する3次元超音波が用いられる．使用する超音波診断装置には断層法だけしかできない装置から，3次元超音波までのすべての機能が備わった高級機種まで多くの種類がある．そこで本書では，検査者，手持ちの装置によって必要な個所を選んで読めるように次のような構成とした．<br><br>・すべての産婦人科医，助産師，技師向け<br>　Ⅰ．経腹法による超音波断層法<br>　Ⅱ．Mモード法<br>　Ⅲ．経腹法による3次元超音波<br>・血流の評価まで行う産婦人科医，助産師，技師向け<br>　Ⅳ．カラードプラ法<br>　Ⅴ．パルスドプラ法<br>・産婦人科医向け<br>　Ⅵ．経腟法<br><br>　本書は，産婦人科超音波検査に携わる多くの方がリーズナブルにお読みいただけるように，臨床診断に関する記述は限定している．産科と婦人科のさまざまな症例における超音波診断については，今までに筆者が執筆または編集した書籍をご覧いただきたい．<br>　本書上梓までに，文光堂の皆様には編集，校閲，図の調整から全体の体裁にいたるまで，読みやすくわかりやすい本となるよう，多大なるご尽力をいただきました．特に，編集部には最後の最後まで大変お世話になり感謝いたします．本書が，産婦人科超音波検査の質の向上，ひいては患者さんや妊婦さんにとって有益となれば幸いです．<br><br>　2026年4月　川越の桜が満開の日<br>　馬場一憲</section><section class="indexes">Ⅰ．超音波断層法 <br>　●超音波断層法の基礎 <br>　　①超音波診断装置の超音波 <br>　　②超音波診断装置はどうやって断層像を表示する？ <br>　　③超音波の安全性 <br>　　〔Dr.Babaの深掘りレクチャー〕 超音波の生体作用　TIとMI <br>　●経腹プローブの操作法 <br>　　①経腹プローブの持ちかた <br>　　②経腹プローブの当てかた <br>　　③胎児の左右 <br>　　〔Dr.Babaの深掘りレクチャー〕 表示の向きの決まり <br>　●超音波診断装置のつまみ・ボタンの使いかた <br>　　①深度（Depth） <br>　　②ズーム（Zoom） <br>　　③ゲイン（Gain） <br>　　④周波数 <br>　　⑤ハーモニックイメージング <br>　　⑥フォーカス <br>　　〔Dr.Babaの深掘りレクチャー〕 フォーカスの仕組み <br>　　⑦走査角 <br>　　⑧コントラスト <br>　　⑨プリセット <br>　　⑩フリーズ <br>　　⑪巻き戻し再生 <br>　　⑫距離計測 <br>　　⑬胎児計測 <br>　　〔Dr.Babaの深掘りレクチャー〕 胎児計測の方法 <br>　●超音波断層法のピットフォール <br>　　①超音波の進行方向と反射面の角度による影響 <br>　　②アーチファクト <br><br>Ⅱ．Mモード法 <br>　●Mモード法 <br>　　①Mモード法の原理 <br>　　②Mモード法の使いかた <br><br>Ⅲ．3次元超音波 <br>　●3次元超音波の基礎 <br>　　①3次元超音波とは <br>　　②3次元像表示までのプロセス <br>　　③3次元超音波の安全性 <br>　　〔Dr.Babaの深掘りレクチャー〕 3次元データセットの操作 <br>　●3次元像表示までの基礎的操作法 <br>　　①3次元超音波への切り替え <br>　　②断層像で3次元走査するところを探す <br>　　③3次元走査 <br>　　④ROIの設定 <br>　　⑤閾値の設定 <br>　　〔Dr.Babaの深掘りレクチャー〕 閾値 <br>　●3次元像のブラッシュアップ <br>　　①3次元像画質選択（3次元走査速度選択） <br>　　②ROIの合わせかた <br>　　③3次元像の回転 <br>　　④不要部分の削除 <br>　　⑤光源の位置の調整 <br>　　⑥シルエットモード <br>　　⑦ブラッシュアップのまとめ <br><br>Ⅳ．カラードプラ法 <br>　●カラードプラ法の基礎 <br>　　①カラードプラ法とパワードプラ法 <br>　　②カラードプラ法でどうやって血流を検出しているのか？ <br>　　③カラー表示領域とフレームレート <br>　　④WMFとPRF <br>　　〔Dr.Babaの深掘りレクチャー〕 血流をカラー表示する原理 <br>　●カラードプラ法のつまみ・ボタンの使いかた <br>　　①カラードプラ法選択とカラーゲイン <br>　　②カラー表示領域の設定 <br>　　③WMFとPRF <br>　　〔Dr.Babaの深掘りレクチャー〕 折り返し現象が起こる理由 <br>　●カラードプラ法のピットフォール <br>　　①血流があるのにカラー表示されない <br>　　②血流の方向を示す色が逆方向の色に表示される <br>　　③血流のない部位がカラー表示される <br><br>Ⅴ．パルスドプラ法 <br>　●パルスドプラ法の基礎 <br>　　①パルスドプラ法の原理 <br>　　②血流の評価法 <br>　　③RIとPIの意味 <br>　　④実際の血流速度の計測 <br>　　〔Dr.Babaの深掘りレクチャー〕 血流速度波形と実際の血流速度 <br>　●パルスドプラ法のつまみ・ボタンの使いかたと血流計測 <br>　　①パルスドプラ法の選択 <br>　　②サンプルボリュームの設定 <br>　　③ベースライン <br>　　④PRFとWMF <br>　　⑤パルスドプラのゲイン <br>　　⑥血流計測 <br>　　⑦角度補正 <br>　　⑧2画面表示法の選択 <br>　　⑨掃引スピード <br>　　⑩ドプラ音の音量 <br>　　〔Dr.Babaの深掘りレクチャー〕 血流計測に関する疑問 <br><br>Ⅵ．経腟法 <br>　●経腟法の基礎 <br>　　①経腟プローブ <br>　　②経腟法のメリットとデメリット <br>　　③経腟法と経腹法の使い分け <br>　●経腟プローブの操作法とつまみやボタンの使いかた <br>　　①経腟プローブの持ちかた <br>　　②表示の向き <br>　　③卵巣の見つけかた <br>　　④経腟法でのつまみやボタンの使いかた <br>　●経腟法のピットフォール <br>　　〔Dr.Babaの深掘りレクチャー〕経腟法のコツ <br><br>■こんなときどうする？<br>　産科<br>　　【経腹法】<br>　　　CASE ① 妊娠初期の胎児がよく見えない． <br>　　　CASE ② 母体腹壁が厚くてよく見えない． <br>　　　CASE ③ 胎児が縦になっていて見えにくい． <br>　　【3次元超音波】<br>　　　CASE ④ 胎児と子宮筋や胎盤との間に十分なスペース（羊水）がない． <br>　　　CASE ⑤ 胎児が取込領域から外れてしまう． <br>　　　CASE ⑥ 3次元像の上下を逆にしたい． <br>　　　CASE ⑦ 回転しても胎児が隠れていて削除線が引けない． <br>　　　CASE ⑧ 間違って必要な部分を削除してしまった． <br>　　　CASE ⑨ 腕が異常に太く見える． <br>　　　CASE ⑩ 3次元像の一部が暗い. <br>　　　CASE ⑪  不要部分が多すぎて胎児がよく見えない． <br>　　【パルスドプラ法】<br>　　　CASE ⑫ 血流速度波形が安定してとれない． <br><br>　婦人科<br>　　【経腹法】<br>　　　CASE ①  経腹法で子宮全体の横断面が観察できない．  <br>　　　CASE ② 卵巣か腸管か区別がつきにくい．<br>　　【経腟法】<br>　　　CASE ③ ゲインを上げても遠くが見えない．<br>　　　CASE ④ 経腟法で子宮が縦になっていて子宮内腔が不明瞭． <br>　　　CASE ⑤ 子宮から発生した腫瘍かどうかはっきりさせたい． <br>　　　CASE ⑥ 経腟法で卵巣が見つからない． <br>　　　CASE ⑦ 経腟プローブを回転すると見えていた対象物が見えなくなる． <br>　　　CASE ⑧ 異所性妊娠が疑われるが子宮外に胎囊が見つからない． <br>　　　CASE ⑨ 黄体か子宮外の胎囊かの判断に迷う． <br>　　　CASE ⑩  囊胞内のエコーが強すぎて充実部分の有無がわかりにくい． <br><br>索引 <br></section></article>
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