文 献oslash) Tamura F Kikutani T Tohara T Yoshida MYaegaki KTongue thickness relates to nutritionalstatus in the elderly Dysphagia ugravedivideoslashugraveugravethornuumluumlyacute-uumlyacuteoslash
ugrave) Nakamori M Hosomi N Takaki S Oda M HiraokaA Yoshikawa M Matsushima H Ochi K Tsuga KMaruyama H Izumi Y Matsumoto MTonguethickness evaluation using ultrasonography canpredict swallowing function in amyotrophic lateralsclerosis patients Clin Neurophysiol ugravedivideoslashyacuteoslashugravethornoslashyacuteyacuteĀ-oslashyacutethornucirc
uacute) Van den Engel-Hoek L Lagarde M Van Alfen NUltrasound of oral and masticatory muscleswhyevery neuromuscular swallow team should have anultrasound machine Clin Anat ugravedivideoslashthornuacutedivideoslashyumluacute-oslashĀuacute
ucirc) Shimizu S Hanayama K Metani H Sugiyama TAbe H Seki S Hiraoka T Tsubahara ARetestreliability of ultrasonic geniohyoid muscle measure-ment Jpn J Compr Rehabil Sci ugravedivideoslashyacutethornuumluuml-yacutedivide
uuml) Feng X Cartwright MS Walker FO Bargoil JH HuY Butler SGUltrasonographic evaluation of genio-hyoid muscle and hyoid bone during swallowing inyoung adults Laryngoscope ugravedivideoslashuumloslashugraveuumloslashyumlyumlyacute-oslashyumlĀoslash
yacute) Shimizu S Hanayama K Nakato R Sugiyama TTsubahara AUltrasonographic evaluation of gen-iohyoid muscle mass in perioperative patientsKawasaki Med J ugravedivideoslashyacuteucircugraveucircthorn-uumlyacute
thorn) Macrae PR Jones RD Myall DJ Melzer TRHucksbee MLCross-sectional area of the anteriorbelly of the digastric musclecomparison of MRIand ultrasound measures Dysphagia ugravedivideoslashuacuteugraveyumluacutethornuuml-uacuteyumldivide
yuml) Ohara Y Hirano H Watanabe Y Edahiro A Sato EShinkai S Yoshida H Mataki SMasseter muscletension and chewing ability in older persons GeriatrGerontol Int ugravedivideoslashuacuteoslashuacuteuacutethornugrave-uacutethornthorn
Ā) Stone M Shawker THAn ultrasound examinationof tongue movement during swallowing DysphagiaoslashĀyumlyacuteoslashthornyuml-yumluacute
oslashdivide) Hsiao MY Chang YC Chen WS Chang HY WangTGApplication of ultrasonography in assessingoropharyngeal dysphagia in stroke patients Ultra-sound Med Biol ugravedivideoslashugraveuacuteyumloslashuumlugraveugrave-oslashuumlugraveyuml
図 ucirc 嚥下時のオトガイ舌骨筋収縮（Mモード）GMオトガイ舌骨筋Ａ収縮距離Ｂ収縮時間
660 Jpn J Rehabil Med Vol 54 No 9 2017
花山耕三他
oslashoslash) Macrae PR Doeltgen SH jones RD Huckabee MLIntra- and inter-rater reliability for analysis of hyoiddisplacement measured with sonography J ClinUltrasound ugravedivideoslashugraveucircdividethornucirc-thornyuml
oslashugrave) Huang YL Hsieh SF Chang YC Chen HC WangTGUltrasonographic evaluation of hyoid-larynxapproximation in dysphagic stroke patients Ultra-sound Med Biol ugravedividedivideĀuacuteuumloslashoslashdivideuacute-oslashoslashdivideyuml
oslashuacute) Yabunaka K Konishi H Nakagami G Sanada HIizuka S Sanada S Ohue MUltrasonographicevaluation of geniohyoid muscle movement duringswallowinga study on healthy adults of variousages Radiol Phys Technol ugravedivideoslashugraveuumluacuteucirc-uacuteĀ
oslashucirc) Kim JH Kim MSLateral pharyngeal wall motion
analysis using ultrasonography in stroke patientswith dysphagia Ultrsound Med Biol ugravedivideoslashugraveuacuteyumlugravedivideuumlyuml-ugravedivideyacuteucirc
oslashuuml) Moriniegravere S Hammoudi K Marmouset F Bakhos DBeutter P Patat FUltrasound analysis of theupper esophageal sphincter during swallowing inthe healthy subject Eur Ann Otohinolaryngol HeadNeck Dis ugravedivideoslashuacuteoslashuacutedivideuacuteugraveoslash-uacuteugraveuuml
oslashyacute) Miura Y Nakagami G Yabunaka K Tohara H HaraK Noguchi H Mori T Sanada HDetecting phar-yngeal post-swallow residue by ultrasound exami-nationa case series Med Ultrason ugravedivideoslashyacuteoslashyumlugraveyumlyuml-ugraveĀuacute
文 献oslash) Tamura F Kikutani T Tohara T Yoshida MYaegaki KTongue thickness relates to nutritionalstatus in the elderly Dysphagia ugravedivideoslashugraveugravethornuumluumlyacute-uumlyacuteoslash
ugrave) Nakamori M Hosomi N Takaki S Oda M HiraokaA Yoshikawa M Matsushima H Ochi K Tsuga KMaruyama H Izumi Y Matsumoto MTonguethickness evaluation using ultrasonography canpredict swallowing function in amyotrophic lateralsclerosis patients Clin Neurophysiol ugravedivideoslashyacuteoslashugravethornoslashyacuteyacuteĀ-oslashyacutethornucirc
uacute) Van den Engel-Hoek L Lagarde M Van Alfen NUltrasound of oral and masticatory muscleswhyevery neuromuscular swallow team should have anultrasound machine Clin Anat ugravedivideoslashthornuacutedivideoslashyumluacute-oslashĀuacute
ucirc) Shimizu S Hanayama K Metani H Sugiyama TAbe H Seki S Hiraoka T Tsubahara ARetestreliability of ultrasonic geniohyoid muscle measure-ment Jpn J Compr Rehabil Sci ugravedivideoslashyacutethornuumluuml-yacutedivide
uuml) Feng X Cartwright MS Walker FO Bargoil JH HuY Butler SGUltrasonographic evaluation of genio-hyoid muscle and hyoid bone during swallowing inyoung adults Laryngoscope ugravedivideoslashuumloslashugraveuumloslashyumlyumlyacute-oslashyumlĀoslash
yacute) Shimizu S Hanayama K Nakato R Sugiyama TTsubahara AUltrasonographic evaluation of gen-iohyoid muscle mass in perioperative patientsKawasaki Med J ugravedivideoslashyacuteucircugraveucircthorn-uumlyacute
thorn) Macrae PR Jones RD Myall DJ Melzer TRHucksbee MLCross-sectional area of the anteriorbelly of the digastric musclecomparison of MRIand ultrasound measures Dysphagia ugravedivideoslashuacuteugraveyumluacutethornuuml-uacuteyumldivide
yuml) Ohara Y Hirano H Watanabe Y Edahiro A Sato EShinkai S Yoshida H Mataki SMasseter muscletension and chewing ability in older persons GeriatrGerontol Int ugravedivideoslashuacuteoslashuacuteuacutethornugrave-uacutethornthorn
Ā) Stone M Shawker THAn ultrasound examinationof tongue movement during swallowing DysphagiaoslashĀyumlyacuteoslashthornyuml-yumluacute
oslashdivide) Hsiao MY Chang YC Chen WS Chang HY WangTGApplication of ultrasonography in assessingoropharyngeal dysphagia in stroke patients Ultra-sound Med Biol ugravedivideoslashugraveuacuteyumloslashuumlugraveugrave-oslashuumlugraveyuml
図 ucirc 嚥下時のオトガイ舌骨筋収縮（Mモード）GMオトガイ舌骨筋Ａ収縮距離Ｂ収縮時間
660 Jpn J Rehabil Med Vol 54 No 9 2017
花山耕三他
oslashoslash) Macrae PR Doeltgen SH jones RD Huckabee MLIntra- and inter-rater reliability for analysis of hyoiddisplacement measured with sonography J ClinUltrasound ugravedivideoslashugraveucircdividethornucirc-thornyuml
oslashugrave) Huang YL Hsieh SF Chang YC Chen HC WangTGUltrasonographic evaluation of hyoid-larynxapproximation in dysphagic stroke patients Ultra-sound Med Biol ugravedividedivideĀuacuteuumloslashoslashdivideuacute-oslashoslashdivideyuml
oslashuacute) Yabunaka K Konishi H Nakagami G Sanada HIizuka S Sanada S Ohue MUltrasonographicevaluation of geniohyoid muscle movement duringswallowinga study on healthy adults of variousages Radiol Phys Technol ugravedivideoslashugraveuumluacuteucirc-uacuteĀ
oslashucirc) Kim JH Kim MSLateral pharyngeal wall motion
analysis using ultrasonography in stroke patientswith dysphagia Ultrsound Med Biol ugravedivideoslashugraveuacuteyumlugravedivideuumlyuml-ugravedivideyacuteucirc
oslashuuml) Moriniegravere S Hammoudi K Marmouset F Bakhos DBeutter P Patat FUltrasound analysis of theupper esophageal sphincter during swallowing inthe healthy subject Eur Ann Otohinolaryngol HeadNeck Dis ugravedivideoslashuacuteoslashuacutedivideuacuteugraveoslash-uacuteugraveuuml
oslashyacute) Miura Y Nakagami G Yabunaka K Tohara H HaraK Noguchi H Mori T Sanada HDetecting phar-yngeal post-swallow residue by ultrasound exami-nationa case series Med Ultrason ugravedivideoslashyacuteoslashyumlugraveyumlyuml-ugraveĀuacute
659Jpn J Rehabil Med Vol 54 No 9 2017
3 摂食嚥下障害の超音波による評価
う報告がなされているoslashugrave)なお動きの定量にあ
たっては測定したい部分をMモードで描出する
ことによりより詳細に検討できる場合があるoslashuacute)
（図 ucirc）その他嚥下時の咽頭側壁の動きoslashucirc)上部食道
括約筋の開き具合oslashuuml)や嚥下後の咽頭残留oslashyacute)を超音
波検査で評価する方法も報告されている
超音波検査の留意点超音波検査を摂食嚥下障害の定量的評価に用い
る場合には検査にあたっていくつか注意すべき点
があるまずプローブを強く押し当てると筋肉の
厚さや断面積が変化したり嚥下運動に支障をき
たすことがあるため超音波ジェルを十分量用い
軽く押し当てても十分な描出が得られるようにす
るまた頭頸部角度やプローブの接触角を一定
にすることが重要であり報告によっては固定具を
用いているものもあるが超音波検査のもつ簡便
性が失われたり嚥下運動に影響する可能性があ
るため配慮が必要である
まとめ超音波検査による摂食嚥下機能の評価は筋な
ど摂食嚥下器官自体の評価から嚥下運動の定量ま
で多彩な報告が認められるしかしVFのよう
に食塊の移動と嚥下運動を全体として捉えること
は困難で嚥下後の咽頭残留や誤嚥についての評
価も不十分であるためVFに代わるものではない
臨床応用を行うにはまだその知見が不足してい
ると考えられ今後の研究の発展に期待したい
文 献oslash) Tamura F Kikutani T Tohara T Yoshida MYaegaki KTongue thickness relates to nutritionalstatus in the elderly Dysphagia ugravedivideoslashugraveugravethornuumluumlyacute-uumlyacuteoslash
ugrave) Nakamori M Hosomi N Takaki S Oda M HiraokaA Yoshikawa M Matsushima H Ochi K Tsuga KMaruyama H Izumi Y Matsumoto MTonguethickness evaluation using ultrasonography canpredict swallowing function in amyotrophic lateralsclerosis patients Clin Neurophysiol ugravedivideoslashyacuteoslashugravethornoslashyacuteyacuteĀ-oslashyacutethornucirc
uacute) Van den Engel-Hoek L Lagarde M Van Alfen NUltrasound of oral and masticatory muscleswhyevery neuromuscular swallow team should have anultrasound machine Clin Anat ugravedivideoslashthornuacutedivideoslashyumluacute-oslashĀuacute
ucirc) Shimizu S Hanayama K Metani H Sugiyama TAbe H Seki S Hiraoka T Tsubahara ARetestreliability of ultrasonic geniohyoid muscle measure-ment Jpn J Compr Rehabil Sci ugravedivideoslashyacutethornuumluuml-yacutedivide
uuml) Feng X Cartwright MS Walker FO Bargoil JH HuY Butler SGUltrasonographic evaluation of genio-hyoid muscle and hyoid bone during swallowing inyoung adults Laryngoscope ugravedivideoslashuumloslashugraveuumloslashyumlyumlyacute-oslashyumlĀoslash
yacute) Shimizu S Hanayama K Nakato R Sugiyama TTsubahara AUltrasonographic evaluation of gen-iohyoid muscle mass in perioperative patientsKawasaki Med J ugravedivideoslashyacuteucircugraveucircthorn-uumlyacute
thorn) Macrae PR Jones RD Myall DJ Melzer TRHucksbee MLCross-sectional area of the anteriorbelly of the digastric musclecomparison of MRIand ultrasound measures Dysphagia ugravedivideoslashuacuteugraveyumluacutethornuuml-uacuteyumldivide
yuml) Ohara Y Hirano H Watanabe Y Edahiro A Sato EShinkai S Yoshida H Mataki SMasseter muscletension and chewing ability in older persons GeriatrGerontol Int ugravedivideoslashuacuteoslashuacuteuacutethornugrave-uacutethornthorn
Ā) Stone M Shawker THAn ultrasound examinationof tongue movement during swallowing DysphagiaoslashĀyumlyacuteoslashthornyuml-yumluacute
oslashdivide) Hsiao MY Chang YC Chen WS Chang HY WangTGApplication of ultrasonography in assessingoropharyngeal dysphagia in stroke patients Ultra-sound Med Biol ugravedivideoslashugraveuacuteyumloslashuumlugraveugrave-oslashuumlugraveyuml
図 ucirc 嚥下時のオトガイ舌骨筋収縮（Mモード）GMオトガイ舌骨筋Ａ収縮距離Ｂ収縮時間
660 Jpn J Rehabil Med Vol 54 No 9 2017
花山耕三他
oslashoslash) Macrae PR Doeltgen SH jones RD Huckabee MLIntra- and inter-rater reliability for analysis of hyoiddisplacement measured with sonography J ClinUltrasound ugravedivideoslashugraveucircdividethornucirc-thornyuml
oslashugrave) Huang YL Hsieh SF Chang YC Chen HC WangTGUltrasonographic evaluation of hyoid-larynxapproximation in dysphagic stroke patients Ultra-sound Med Biol ugravedividedivideĀuacuteuumloslashoslashdivideuacute-oslashoslashdivideyuml
oslashuacute) Yabunaka K Konishi H Nakagami G Sanada HIizuka S Sanada S Ohue MUltrasonographicevaluation of geniohyoid muscle movement duringswallowinga study on healthy adults of variousages Radiol Phys Technol ugravedivideoslashugraveuumluacuteucirc-uacuteĀ
oslashucirc) Kim JH Kim MSLateral pharyngeal wall motion
analysis using ultrasonography in stroke patientswith dysphagia Ultrsound Med Biol ugravedivideoslashugraveuacuteyumlugravedivideuumlyuml-ugravedivideyacuteucirc
oslashuuml) Moriniegravere S Hammoudi K Marmouset F Bakhos DBeutter P Patat FUltrasound analysis of theupper esophageal sphincter during swallowing inthe healthy subject Eur Ann Otohinolaryngol HeadNeck Dis ugravedivideoslashuacuteoslashuacutedivideuacuteugraveoslash-uacuteugraveuuml
oslashyacute) Miura Y Nakagami G Yabunaka K Tohara H HaraK Noguchi H Mori T Sanada HDetecting phar-yngeal post-swallow residue by ultrasound exami-nationa case series Med Ultrason ugravedivideoslashyacuteoslashyumlugraveyumlyuml-ugraveĀuacute
660 Jpn J Rehabil Med Vol 54 No 9 2017
花山耕三他
oslashoslash) Macrae PR Doeltgen SH jones RD Huckabee MLIntra- and inter-rater reliability for analysis of hyoiddisplacement measured with sonography J ClinUltrasound ugravedivideoslashugraveucircdividethornucirc-thornyuml
oslashugrave) Huang YL Hsieh SF Chang YC Chen HC WangTGUltrasonographic evaluation of hyoid-larynxapproximation in dysphagic stroke patients Ultra-sound Med Biol ugravedividedivideĀuacuteuumloslashoslashdivideuacute-oslashoslashdivideyuml
oslashuacute) Yabunaka K Konishi H Nakagami G Sanada HIizuka S Sanada S Ohue MUltrasonographicevaluation of geniohyoid muscle movement duringswallowinga study on healthy adults of variousages Radiol Phys Technol ugravedivideoslashugraveuumluacuteucirc-uacuteĀ
oslashucirc) Kim JH Kim MSLateral pharyngeal wall motion
analysis using ultrasonography in stroke patientswith dysphagia Ultrsound Med Biol ugravedivideoslashugraveuacuteyumlugravedivideuumlyuml-ugravedivideyacuteucirc
oslashuuml) Moriniegravere S Hammoudi K Marmouset F Bakhos DBeutter P Patat FUltrasound analysis of theupper esophageal sphincter during swallowing inthe healthy subject Eur Ann Otohinolaryngol HeadNeck Dis ugravedivideoslashuacuteoslashuacutedivideuacuteugraveoslash-uacuteugraveuuml
oslashyacute) Miura Y Nakagami G Yabunaka K Tohara H HaraK Noguchi H Mori T Sanada HDetecting phar-yngeal post-swallow residue by ultrasound exami-nationa case series Med Ultrason ugravedivideoslashyacuteoslashyumlugraveyumlyuml-ugraveĀuacute
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