透明中隔腫瘍—脳血管写所見を中心にして

TUMOR OF THE SEPTUM PELLUCIDUM

Ｉ．はじめに

　透明中隔腫瘍は比較的まれな疾患とされていたが，近年診断技術の進歩とともに，その報告も増加してきた。しかしこれら報告例においても，臨床診断の的中率はきわめて低く，剖検により初めて本腫瘍と判明したものも多い。また従来から気脳写が唯一の診断根拠とされ，脳血管写についての検討は現在までなされていない。われわれは最近6例の透明中隔腫瘍を経験したが，深部静脈系に注目することにより脳血管写上に特異な変化を示すことがわかつた。さらに腫瘍の原発部位を推定し，手術方法を決定するうえで，気脳写よりすぐれている点もあることを知つた。全症例とも剖検あるいは手術により確診を得たので，脳血管写所見を中心に報告し，若干の考按を試みたい。

Air study used to be utilized for diagnosis of the septum pellucidum tumor. Upon recent experience on 6 cases of this tumor, the cerebral angiography is also a powerful weapon for the diagnosis. As for the arterial phase, abnormal vasculature was observed in only 1 out of this series and 4 of them showed mere ventricular dilatation.

Topographic analysis is mainly based upon the deep cerebral venous phases such as follow.

1. The downward shift of the internal cerebral vein and the splitting of the anterior portions.

2. The engorgement and enhacement of the an-terior septal vein or posterior septal vein. Also splitting of the septal veins on A-P view.

3. The dissociation of the septal veins or medical arterial veins on A-P view.

4. Tumor stain in the capillary or venous phase.

5. Cases of this series were underwent the surgical interventions. Two cases expired postoperatively and total removal was achieved in 3 cases.

The diagnosis of these cases was possible in refe-rence to the angiographical findings. The analysis of the vascularity of the tumor can also give a clue to the preoperative diagnosis of malignancy.

A more careful interpretation of the angiograms is preferable to obtain the safer and more detail diagnosis accordingly.