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用“阿米派克(甲泛葡胺)CT脑室造影术诊断第三脑室囊肿(作者译)”

[Diagnosis of IIIrd ventricular cyst with "amipaque (metrizamide) CT ventriculography (author's transl)].

作者信息

Hayashi T, Honda E, Shyojima K, Shirahama M, Watanabe M, Kuramoto S

出版信息

No To Shinkei. 1978 Jul;30(7):771-6.

PMID:308373
Abstract

The patient is a 17-year-old female. She was suffering from dwarfism, irregular menstruation and obesity. Out of the dwarfism, there were no other neurological abnormalities. The serious clinical examinations were performed, and the cerebral angiography and the CT scan demonstrated the findings of the obstructive hydrocephalus. Namely, enlarged IIIrd ventricle and small IVth ventricle were observed with routine CT scan. Because these findings on CT scan, we thought the hydrocephalus was based on the aqueductal stenosis. The vertebral angiography showed stretched posterior medial choroidal arteries and compressed the basilar tip posteriorly and inferiorly. Moreover, the carotid-angiography demonstrated the following findings, unrolling of the anterior cerebral arteries laterally stretched bilateral lenticulostriate arteries laterally shifted sylvian groups of the middle cerebral arteries, and stretched bilateral internal cerebral veins. Judging from that angiographic findings and CT scan, we thought there would be cystic tumor in the IIIrd ventricle. However, we suspected the IIIrd ventricular tumor, we were not able to differentiated it from the enlarged IIIrd ventricle itself exactly. Because, it's density in CT scan was equaled with that the cerebrospinal fluid. According to above facts, we performed "Amipaque CT ventriculography through the ventricular catheter after V-P shunt. By "the Ampiqque CT ventriculography" we found exactly there was large cystic tumor in the IIIrd ventricle. Their manifestation and some differential diagnosis were discused.

摘要

患者为一名17岁女性。她患有侏儒症、月经不调和肥胖症。除侏儒症外,无其他神经学异常。进行了全面的临床检查,脑血管造影和CT扫描显示了梗阻性脑积水的表现。具体而言,常规CT扫描观察到第三脑室扩大和第四脑室变小。基于CT扫描的这些表现,我们认为脑积水是由导水管狭窄所致。椎动脉造影显示脉络膜后内侧动脉伸展,并向后下方压迫基底动脉尖端。此外,颈动脉造影显示了以下表现:大脑前动脉展开,双侧豆纹动脉向外伸展,大脑中动脉的外侧裂组向外移位,双侧大脑内静脉伸展。根据血管造影结果和CT扫描,我们认为第三脑室内可能存在囊性肿瘤。然而,尽管我们怀疑第三脑室肿瘤,但无法将其与扩大的第三脑室本身准确区分开来。因为在CT扫描中其密度与脑脊液相同。基于上述情况,我们在脑室-腹腔分流术后通过脑室导管进行了碘曲仑CT脑室造影。通过“碘曲仑CT脑室造影”,我们确切发现第三脑室内存在巨大囊性肿瘤。对其表现及一些鉴别诊断进行了讨论。

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