脳血管連続撮影における若干の経験について

SOME EXPERIENCES ON THE CEREBRAL SERIO-ANGIOGRAPHY

まえがき

　神経科，神経外科領域における脳血管撮影法のもつ意義については，もはや論議を付け加える必要はない。しかし多くの場合，その血管像のうちただ単一な動脈相あるいは静脈相のみがとりあげられ，その形態的変化だけが論議の中心であつた。いうまでもなく血管撮影法は単に血管の形態的変化のみを追究する具ではなく，その機能，すなわち血流動態を把握するのにも優れた方法であり，この目的のために連続撮影法（SeriographyおよびCinematography）なるものがすでに古くから一部の研究者の間では活用されていたが，これにはそのための特殊な装置が必要であり，今日わが国においても，いまだ広く普及していない状態である。

　この血管連続撮影装置に関しては，本邦においても若干の創作および改良が企てられており，いまだ完壁の域には達していないが，われわれはほぼ実用に供し得る製品を得て，これに関する経験を積み，臨床医の立場から若干の知見を得たので，これを報告したい。

Angiography should be one of the excellent means to investigate the function of blood vessels. Up to the present, however, only the morphological changes of blood vessels in arterio and phlebograms were discussed. Since April 1961, authors could have 144 serio-angiographies in 79 neurosurgical cases, and some informations were obtained for the clini-cal practice.

(1) For the most desirable observation of the cerebral blood current by means of serio-angiography, it is necessary to use as small amount of contrast as possible, to make the length of contrast-mixed blood stream as short as possible. Injecting about 5~6 cc. of 76 per cent Urografin into carotid artery, cerebral arterial phase can be taken during the first 3~4 sec. then, capillary phase during the next 2~3 sec. and venous phase during the next 9~12 sec.

(2) According to serioangiography, the del-ayed cerebral circulation time was detected in the cases of vascular sclerosis, and in addition, it was found out that the capillary and venous circulatory delay took important roles in this condition. It was also detected by serioangiography that the varied incidence of visualization of posterior communicating and posterior cerebral artery in carotid angio-graphy might be caused by the slight differ-ences of contrast injecting pressure in carotid artery, as well as the slight differences of photo-timing.