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Brain and Nerve No to Shinkei Volume 25, Issue 1 （January 1973）

Brain and Nerve 脳と神経 25巻1号（1973年1月発行）

Japanese English

研究

小児硬膜下血腫における脳スキャンの意義について BRAIN SCANNING OF SUBDURAL HEMATOMA IN INFANTS AND CHILDREN 露無松平 ¹ , 平塚秀雄 ¹ , 大畑正大 ¹ , 橋本邦雄 ¹ , 松島善治 ¹ , 稲葉穰 ¹ Matsutaira Tsuyumu ¹ , Hideo Hiratsuka ¹ , Masahiro Ohata ¹ , Kunio Hashimoto ¹ , Yoshiharu Matsushima ¹ , Yutaka Inaba ¹ ¹東京医科歯科大学脳神経外科 ¹Department of Neurosurgery, Tokyo Medical and Dental University School of Medicine pp.19-25

発行日 1973年1月1日 Published Date 1973/1/1

DOI https://doi.org/10.11477/mf.1406203254

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Abstract 文献概要
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　Peytonら^24）が初めて1952年放射性Diiodofluoresceinを使つて慢性硬膜下血腫を診断して以来，放射性同位元素による脳スキャンは硬膜下血腫の診断上有効であると認められてきた。しかし小児においては，その有用性を疑問視する報告もみられる^19）。

　われわれは15例の小児硬膜下血腫に^99mTc-pertechne—tate （以下^99mTcと略す）による脳スキャンを27回行なった。そして硬膜下血腫の^99mTcによるスキャン陽性像の機序について観察した。

The relative merits of brain scanning for infantile subdural hematomas are not yet well defined. We performed ^99mTc-pertechnetate brain scanning 27 times for 15 infantile subdural hematoma cases. These scanning gave positive results in 72% of cases, doubtfully positive in 24%, but negative in 4%. Therefore the brain scan, because of its ease of performance, lack of morbidity and relative accuracy should assume an important role in the screening of patients with suspected subdural hematomas.

In selected cases, scans were obtained after appropriate delay periods as well as at conventional scanning times. In some cases, scans which were initially interpreted as borderline or negative were read as definitely abnormal on delayed studies. So delayed scans are a valuable addition to diagnostic technique for subdural hematomas.

The radioactivity in serial blood and subdural samples was measured in a well-type scintillation counter. This study clarified some of the biodynam-ic mechanism underlying the successful detection of infantile subdural hematomas by external scintil-lation scanning. Our result is that both subdural fluid and subdural neomembrane influence the production of a positive scan, but whether the isotope is localized primarily in the membrane or in the subdural fluid depends upon the kind of radioisotope used, hematoma age, the nature of subdural fluid and the time interval between injec-tion of radioisotope and scanning.

The total volume of the subdural space is deter-mined by the isotope dilution method. This tells more of clinical value than does the simple 2- dimentional gamma ray immage of the subdural hematoma. Determination of the total size of the hematoma may be important in planning therapy.