電腦斷層攝影檢查所見對稱性側腦室擴大的臨床意義

The Clinical Significance of Symmetric Ventricular Dilatation on C.T. Scan.

陳俊雄(Chin-Hsiung Chen) ； 劉青山(Chin-Sen Liu) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 15卷1期 (1990/03) Pp. 35-43

摘要

C. T. Scan對於腦室擴大的病患，亳無問題的可以提供最好的診斷，不但可以知道腦室及腦池的大小，阻塞位置，並可經由對比劑檢查－水溶性造影劑腦池攝影(CT cisternography)以了解腦脊髓液的流通狀況。
本文收集333例腦室擴大之病患，經由臨床病史及各種資料的研判，阻塞型水腦症其病史大都在二個星期到三個月間發病，分別為非交通性者55.8%，交通性者66.2%；而顱內壓增加的症狀，前者為73%，後者為22.9%；昏迷指數(GCS)低於8者，前者為15.4%，後者為6.7%；病因則非交通性者以腫塊壓迫為主(68/104)，尤其後顱窩病變最多，其中更以小腦虫部的腫瘤為主要者(21/68)；而交通性者以感染性炎症(35/74)，及蜘蛛膜下腔出血(21/74)，為主要病因。
本文所提供的統計資料，期能早期預知某些疾病在某一特定的時間容易引起水腦症(hydrocephalus)以達早期診斷治療的效果，造福病患。

並列摘要

Computed tomography has proved to be a reliable method in evaluating the patiebts with ventricular eblargement.
It provides information about the size of ventricular and cisternal systems, the site of obstruction and, through water-soluble contrast cisternography, the status of CSF circulation.
In this report, a total of 333 cases with ventricular enlargement were studied. In most of the cases, onset of the symptoms and signs of obstructive hydrocephalus was from two weeks ot three months. Anong them, 55.8%had obstruction and 66.2% had communicating obstruction.
Increased intracranial pressure was evident in 73% of the former and 22.9% of the latter.
GCS less than 8 was noted in 15.4%of the former and 6.7% of the latter. Non-communicating obstruction was mainly (21/68) causedhy (68/104) ? mass effect, especially posterior fossa lesions. Among them, 21 had tumor mass over the cerebellar vermis. Causes of communicating obstruction included infection (35/74) and subarachnoid hemorrhage (21/74).
In this report, etiology and onset of complicated hydrocephalus were thoroughly studied, hokefully to lead the clinicians to early diagnosis and dubesquent shunting shunting procedures.