Digital video subtraction systemによる髄液鼻漏の局在診断

The Diagnostic Method of Localization of Cerebrospinal Fluid Rhinorrhea by Digital Video Subtraction System

I．はじめに

　髄液漏の局在診断法はmetrizamide CT cisternography^2,4,11,14）が多く使用されるようになり進歩したが，しかしながらCTでは短時間の静的画像で判断するにすぎず，直接に髄液が漏れでる動的な様子を連続して観察することができない．そこでわれわれは初めての試みとして，digital video subtraction systemを使用し少量の造影剤を頭蓋底の脳槽内へ注入し，髄液鼻漏の患者の漏孔を直接確認することができたので報告する．

Demonstration of the exact site of the dural fistula in cerebrospinal fluid rhinorrhea is difficult. Previous re-ports present the methods of metrizamide cisterno-graphy combined with both hypocycloid tomography and computed tomography. But in these methods, direct, dynamic, actual and real-time visualization of the fistula with minimal dose of metrizamide is rather diffi-cult. By using digital video subtraction system (Philips DVI-2CV) , we could visualize the direct, dynamic and actual site of fistula with small amount of metrizamide instilled into the suboccipital subarachnoid space with the patient prone position.