雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Brain and Nerve No to Shinkei Volume 35, Issue 10 （October 1983）

Brain and Nerve 脳と神経 35巻10号（1983年10月発行）

Japanese English

原著

血行再建術後の脳血流量の変化—断層血流測定法による検討 CHANGES IN CBF PATTERN AFTER BYPASS SURGERY STUDIED BY CT WITH XE ENHANCEMENT 田村晃 ¹ , 瀬川弘 ² , 中込忠好 ³ , 吉益倫夫 ³ , 木村一元 ⁴ , 上田裕一 ⁴ , 江口恒良 ⁵ , 佐野圭司 ¹ Akira Tamura ¹ , Hiromu Segawa ² , Tadayoshi Nakagomi ³ , Norio Yoshimasu ³ , Kazurnoto Kimura ⁴ , Yuichi Ueda ⁴ , Tsuneyoshi Eguchi ⁵ , Keiji Sano ¹ ¹帝京大学脳神経外科 ²富士脳障害研究所脳神経外科 ³東京厚生年金病院脳神経外科 ⁴独協大学脳神経外科 ⁵亀田総合病院脳神経外科 ¹Department of Neurosurgery, Teikyo University School of Medicine ²Fuji Brain Institute ³Tokyo Kosei-Nenkin Hospital ⁴Dokkyo University School of Medicine pp.975-981

発行日 1983年10月1日 Published Date 1983/10/1

DOI https://doi.org/10.11477/mf.1406205199

PDF(7552KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

　抄録　局所分解能に優れたCTによる断層血流測定法により，血管吻合術前後の循環動態の変化を検討した。対象は，TIA,RINDで発症した中大脳動脈閉塞症2例，梗塞発作で発症した内頸動脈閉塞症2例，モヤモヤ病1例で，測定は，最終発作より初回は2週〜2ヵ月後，術後は2〜5ヵ月後に行なわれた。術前には，対側を含めた広範な血流低下傾向が認められたが，術後全例で血流増加がみられた。TIA,RIND例では，CTで異常の認められない虚血中心部で著明な血流増加が認められ，1例では正常値以上のhyper—emiaがみられた。また，虚血周辺部から対側にまで血流増加がみられた。梗塞例では，CT上低吸収域の病巣中心部では術後も血流増加はみられなかったが，病巣周辺で著明な増加が認められ，1例では　hyper—elniaが認められた。梗塞例においても，同側遠隔部や対側の血流増加が認められた。この結果より，血管吻合術後には，吻合部周辺のみならず，同側遠隔部や大脳深部から対側を含めた広範な脳内血流再配分が起こることが推定される。

Using a new method for rCBF measurement by serial CT scanning with non-radioactive xenon enhancement, CBF was measured before and/or after microsurgical anastomosis in five cases of focal cerebral ischemia. Materials and Methods : Studies were carried out on 2 cases of MCA occlusion, 2 of IC occlusion, and 1 of "Moya-moya" disease. CBF was measured both before and after surgery in 4 cases, and the remaining case was measured after anastomosis. Pre-operative CBF was measured 1.4±0.5 months after the onset and post-operative CBF was 2±1 months after surgery. While 50 to 70% non-radioactive xenon was inhaled for 25 min and then discon-tinued, serial CT scanning was carried out every 3 min. K-map (clearance rate), 2-map (partition coefficient), and CBF-map were displayed on CRT as images of each value. Results : In all cases, initial pre-operative CBF decreased not only in the ipsilateral hemisphere, but also in the con-tralateral hemisphere. Especially in the major stroke cases, CBF reduction in the low density areas seen in CT was more than 75% of normal values. After microsurgical anastomosis, CBF increased in both hemispheres. In two cases of reversible ischemic attacks without any change in CT, the CBF markedly increased in central areas of ischemia and the CBF values became higher than normal value, that is hyperemia. On the contrary, in the central areas of the major stroke cases, that is, the low density areas in CT, CBF was still very low (under 25% of normal value) after anastomosis. However, in these cases, marked hyperemia was seen in the surrounding area of ischemic focus.