中脳動脈の血管病変—レ線診断法を中心として

THE VASCULAR LESIONS OF THE MIDDLE CEREBRAL ARTERY: WITH SPECIAL EMPHASIS ON ANGIOGRAPHIC DIAGNOSIS

　Monizにより脳血管造影法が創始されて以来，それ以前には剖検によつてのみ確証された脳血管病変のあるものが生前直接認められるようになつた。特に最近の造影剤は小量で良好なコントラストを与え又毒性も著しく低いので，患者は繰返しの注入に耐えるようになり，病変の存在は勿論のこと，手術侵襲に際して不可欠な病変の適確な局在ならびにその性質に関するデーターをも提供するようになつた。

　レントゲン装置の進歩，就中連続撮影装置の使用は普通のレ線像で了解し得ないような或る種の脳血管病変も，力動的観点から把握し得るようになつた^30）。

Five cases of the vascular lesions of the middle cerebral artery,confirmed by cerebral angiography for a period of ten months begi-ning January 1960 at the Tokyo Medical & Dental University Hospital,were reported.

The angiographic examination was carried out by the author himself.Lateral and antero-posterior views were made in all cases,in-jecting 5 or 6cc of 60% Urografin for each view.The radiographic contrast and filling of the contrast medium were excellent in all angiograms,and there was no complication associated with the procedure.

In three out of five cases the diagnosis was established based upon the serial angio-gragraphic findings. Although higher radia-tion hazards to the patient as well as the angiographer and expense, comparing with the conventional angiographic technique, shoud not be neglected,the serial angiogra-phy might well be thought indispensable for the investigation on some of the vascular lesions of the brain.

In addition to roentgen diagnosis,the clini-cal diagnostic and the therapeutic aspects of the lesions were discussed with the special attention to the modern trends of the medi-cal and surgical treatments.