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はじめに
1957年,Bell. R. L. 1)により,脳室内に注入された131IHSAのカウント数の変化が髄液の流れを知る上に有効な方法であると報告されて以来,スキャンニング法による形態研究と共に,経時的な131IHSAの拡散,血中移行等,動的な検討が行なわれているが2)3),最近では種々のアイソトープが利用され,99mTC4),198Colloidalgold5),125I6),74As7),84Ga7)等その半減期を考慮し使用され,各々の核種による拡散の動態が報告されている。又,スキャンニング法の進歩により,より短時間に髄腔内に注入されたアイソトープの動態を判定し得る様になつた。しかし本邦では髄液中に投与されたアイソトープの動態に関してはわずか8)の報告がみられるのみである。
私達は131IHSAを用い,スキャンニング法による形態上の問題と共に,血液移行の状況,髄腔内拡散速度を追求し,この方法の診断的価値を検討した。
Doses of 30-150 ,μCi of 131IHSA were injected into the ventricular and spinal C. S. F., the patterns of 131IHSA distribution in the C. S. F. cavity, and the transference of 131IHSA to the blood were ex-amined. We found the diagnostic values and some problems of these method as follows,
1. In the Cases of Hydrocephalus, the findings of Intraventricular 131HSA scanning were not suf-ficient to make correct Diagnosis of noncommunicat-ing hydrocephalus.
Intrathecal 131IHSA scanning might be needed.
2. The detection of the patency of shunt oper-ation was impossible by the scanning using 131IHSA, but the alteration of the counts in the blood gave referable information on this problem.
3. 131IHSA injected into the Lumbal C. S. F. reached the Basal cistern between 2-4 hours later. Slower cranialward movement of 131IHSA suggested the abnormality of C. S. F. flow.
4. Intrathecal 131IHSA scanning was thought to be the most effective method to differenciate "nor-mal" pressure hydrocephalus from hydrocephalus "ex vacuo."
5. To discover C. S. F. Rhinorrhea, Intrathecal 131IHSA was also the method required.
6. The measurement of 131IHSA transference to the blood under the strict and correct condition will be able to give us much useful information about the dynamics of C. S. F.
7. We feel it is meanless to classify hydroce-phalus to be communicating and noncommunicat-ing. From the point of view of C. S. F. dynamics, more appropriate clasfications have to be considered.
8. The examination using Isotopes has many advantages in making clear the causes of diseases such as Intracerebral cysts or Subdural cellection of C. S. F. or others.
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