Japanese
Title正常圧水頭症におけるX線CTと脳槽シンチグラフィの臨床的検討
Subtitle原著
Authors須井修*, 前田敏男*, 松田博史*, 石田博子*, 道岸隆敏*, 久田欣一*, 林実**
Authors(kana)
Organization*金沢大学医学部核医学教室, **脳神経外科教室
Journal核医学
Volume20
Number5
Page651-657
Year/Month1983/6
Article原著
Publisher日本核医学会
Abstract「要旨」正常圧水頭症の診断で脳室短絡術が施行された14例について脳槽シンチグラフィの所見を再検討し, X線CTの所見や脳室短絡術の結果と比較した. 手術の効果は7例に認めた. 脳室短絡術の効果と最も良く一致した脳槽シンチグラフィ所見は, 48時間像における両側クモ膜下腔閉塞による脳室描画であった. この所見を示した7例中6例では手術の効果を認めたが, 頭部カウント数の5時間値に対する24時間値の比が0.5以下を示し, X線CTで脳実質の損傷を示した1例では手術の効果が得られなかった. なお, 24時間像における脳室描画や頭部RIクリアランスの遅延は手術効果の予測に役立たず, 48時間像が重要であることがわかった. X線CTで, シルビウス裂がはっきりしない8例中6例に手術の効果を認めた. 臨床所見とX線CTにて正常圧水頭症が疑われる症例に脳槽シンチグラフィを追加することは, 脳室短絡術の効果予測に有用である.
Practice臨床医学:一般
Keywordsnormal pressure hydrocephalus, cerebrospinal fluid shunt, radionuclide cisternography, X-ray CT
English
TitleClinical Evaluation of Radionuclide Cisternography and X-ray CT in Normal Pressure Hydrocephalus
Subtitle
AuthorsOsamu SUI*, Toshio MAEDA*, Hiroshi MATSUDA*, Hiroko ISHIDA*, Takatoshi MICHIGISHI*, Kinichi HISADA*, Minoru HAYASHI**
Authors(kana)
Organization*Department of Nuclear Medicine, **Department of Neurosurgery, School of Medicine, Kanazawa University
JournalThe Japanese Journal of nuclear medicine
Volume20
Number5
Page651-657
Year/Month1983/6
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] The retrospective reevaluations of the radionuclide cisternogram and X-ray CT were studied in 14 cases in whom cerebrospinal fluid shunt were instaled under the diagnosis of normal pressure hydrocephalus after these examinations. Only half of these cases showed clinical improvement after shunt operation. The most reliable finding of the cisternography was the persistent ventricular visualization with bilateral block at subarachnoid space on 48 hour- image. These findings were observed in seven cases, and all of them but one case showed clinical improvement after shunt installation. The exceptional one case in whom shunt was not effective showed very rapid clearance of radionuclide from the head in spite of the persistent ventricular visualization and non-visualized subarachnoid space on 48 hour-image. The cisternogram of the other case whose shunt was effective showed the transient ventricular visualization upto 24 hour, the unilateral subarachnoidal space block upto 48 hour and the prominently delayed clearance of radionuclide from the head. The cisternographic findings of the delayed radionuclide clearance and the ventricular visualization on 24 hour-image were insufficient to hope the shunt effect. The most hopeful findings of the X-ray CT was the poor-visualization of Sylvian fissure at least on two cross sections. These findings were observed in eight cases, and six out of them showed clinical improvement after shunt operation. But the poor-visualization of Sylvian fissure is not a specific sign for normal pressure hydrocephalus. We concluded that the abnormal findings on 48 hour-image of cisternography are correlated well with the effect of cerebrospinal fluid shunt in normal pressure hydrocephalus, and the cisternobraphy is still very useful in the chosen patients with clinical and X-ray CT findings.
PracticeClinical medicine
Keywordsnormal pressure hydrocephalus, cerebrospinal fluid shunt, radionuclide cisternography, X-ray CT

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