IA-DSAを用いた脳循環時間測定による閉塞性脳血管障害の循環動態に関する臨床的研究第二編 : 閉塞性脳血管障害例における検討 <原著>

Clinical Investigations of Hemodynamics of Obstructive Cerebrovascular Disease by Measurement of Cerebral Circulation Time by Using Intra-arterial Digital Subtraction Angiography : Examination in the patient with obstructive cerebrovascular disease

Hatayama Takashi

広島大学医学雑誌

Medical journal of Hiroshima Universtiy

[PISSN] 0018-2087

[NCID] AN00213202

各種閉塞性脳血管障害症例に対して, 経動脈性digital subtraction angiography(IA-DSA)を用いて, 脳循環時間(cerebral circulation time : CCT)を測定し, stable Xe-CT法により測定した脳血流量(cerebral blood flow : CBF)と比較検討した。閉塞性脳血管障害例は, 内頸動脈狭窄症例, 中大脳動脈狭窄症例, 中大脳動脈閉塞症例, モヤモヤ病を対象とした。各病態ともに正常例に比してCCTは延長しており, 特に中大脳動脈閉塞症における側副血行路不良例およびモヤモヤ病において著明であった。またCBFはCCT延長例で低下していたが, モヤモヤ病だけはCCT延長にも関わらずCBFは保たれており, 病態の特殊性が示唆された。各閉塞性脳血管障害例において, CBFとともにCCTを評価することによって, 側副血行路の良否を判定できた。CCT測定は, 各種閉塞性脳血管障害の病態把握, 血行再建術の適応, 効果判定の有用な指標であることが判明した。

The cerebral circulation time (CCT) estimated by IA-DSA was compared with cerebral blood flow (CBF) measured by Xenon-CT. There were 130 patients with obstructive cerebrovascular diseases, which consisted of 57 internal carotid artery stenosis (ICAS), 28 middle cerebral artery stenosis (MCAS), 29 mid dle cerebral artery occlusion (MCAO), and 16 moyamoya disease. The CCT of these patients was more elongated than that of the control group. Especially in the patients of MCAO with the poor collateral circulation and moyamoya disease, the CCT was statistically elongated. The CCT has the significant positive correlation with CBF. However, only in moyamoya disease, the CBF was reserved in spite of CCT was increased. After vascular reconstructive surgery, the CCT was shortened in the patients. I conclude that the CCT is considered as the sensitive indicator for the collateral circulation, and to be useful to detect the evaluation of the hemodynamics and the surgical indication for the obstructive cere-brovascular disease.

Cerebral circulation time

Intra-arterial digital subtraction angiography

Obstructive cerebrovascular disease

Medical sciences [ 490 ]

jpn

広島大学医学出版会

[Created] 2006-03-21

[ISSN] 0018-2087

[NCID] AN00213202