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Brain and Nerve No to Shinkei Volume 26, Issue 9 （September 1974）

Brain and Nerve 脳と神経 26巻9号（1974年9月発行）

Japanese English

原著

慢性硬膜下血腫のR．I．とりこみについて ACCUMULATION OF RADIOACTIVE ISOTOPE IN CHRONIC SUBDURAL HEMATOMA 郭隆璨 ¹ , 青木晃 ¹ , 鈴木二郎 ¹ , 中村護 ² Ryungchan Kwak ¹ , Akira Aoki ¹ , Jiro Suzuki ¹ , Mamoru Nakamura ² ¹東北大学医学部附属脳疾患研究施設脳神経外科 ²東北大学放射線科 ¹Division of Neurosurgery, Institute of Brain Diseases, Tohoku University School of Medicine ²Department of Radiology, Tohoku University School of Medicine pp.907-917

発行日 1974年9月1日 Published Date 1974/9/1

DOI https://doi.org/10.11477/mf.1406203597

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Abstract 文献概要
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I．緒言

　慢性硬膜下血腫は脳神経外科領域においては日常しばしば遭遇する疾患の一つであり，その診断と治療は比較的容易であるにもかかわらず病因および病態生理に関しては不明のことが多く，今日なお本態不明の疾患といわざるを得ない^10）。放射性同位元素（以下R．I．と略す）を用いた慢性硬膜下血腫の病態生理解明への努力もなされてきてはいるが，血腫および被膜のR．I．とりこみをめぐつても種々な相異なる報告と見解の違いがみられる^{4）5）8）12）20）}。従つて診断率が80〜90％^{2）3）11）}（にも達する脳スキャンニングの診断根拠である陽性スキャンの本態についてさえも，その多くは推論の域を出ないのが現状である。

　われわれは44例の慢性硬膜下血腫に対して種々のR．I．を用いて血腫および血腫被膜へのR．I．とりこみを計測し，これらのR．I．とりこみが核種，R．I．投与後血腫採取までの時間および血腫の新旧などによつて異なるという知見を得たので報告する。

The present study was made to investigate ac-cumulation of radioactive isotope (R. I.) in the 44 cases of chronic subdural hematoma. As the R. I., ²⁰³Hg-chlormerodrin, mlig-chlormerodrin, ¹¹³In-EDTA, ¹³¹I-RISA and ⁵¹Cr-RBC (red blood cell) were used. After intravenous injection of R. I. all cases were operated and R. I. counts of hematoma, outer and inner membrane were measured with scintillation counter.

1. The R. I. accumulation of hematoma, outer and inner membrane showed that ²⁰³Hg^≒197Hg ≒^113mIn>RISA>⁵¹Cr-RBC. The ratio of the posi-tive accumulation of R. I. were 100% in ²⁰³Hg, ¹⁹⁷Hg, and ^113mIn, 96.3% in RISA and 36.8% in ⁵¹Cr-RBC in hematoma. The average of the ratio of R. I. count of hematoma for that of peripheral blood were 33. 7% in ²⁰³Hg, 36.0% in ¹⁹¹Hg, 35.1% in ^113mIn, 7.9% in RISA and 3.6% in ⁵¹Cr.

2.As for the time of sampling after administra-tion of R. I. in hematoma no significant difference was observed with ²⁰³Hg. But RISA and ⁵¹Cr-RBC of the 24-hours group were more than that of the 4-hours group. In the outer and inner membrane,the R. I. accumulation of the 4-hours group was more than that of 24-hours group in all R. I..

3.On the symptom of chronic subdural hemato-ma, no significance was observed in ²⁰³Hg and RISA in hematoma. But when the symptom reached to its peak or symptom was heavy, accumulation of ⁵¹Cr became much more than that the symptom was light. Any fixed tendencies were not given in both the outer and inner membrane in all R. I..

4.On the term from the onset of head injury to the R. I. administration the accumulation of ⁵¹Cr was as much as the term was short in hematoma. The outer membrane showed no fixed tendencies, while the R. I. accumulation in inner membrane was as much as the term was long.

On the term from the onset of chronic subdural hematoma to the R. I. administration, the accumu-lation of ⁵¹Cr was as much as the term was short in hematoma. The accumulation of ²⁰⁹Hg and RISA were as much as the term was long in outer and inner membrane.