뇌경색증에 있어서 CT와 Dynamic CT의 임상적 가치에 대하여 = Clinical values of CT and Dynamic CT in Brain Infarction

다국어 초록 (Multilingual Abstract)

With the advent of faster scan time and new computer program, a scanning technique called "dynamic computed tomography" has become possible. Dynamic computed tomography consists of performing multiple rapid sequence scans after injection of contrast material. The authors have evaluated the clinical uesfulness of computed tomography and dynamic computed tomography of 93 patients with brain infarction and/or ischemia during the period of 17 months from April 1983 to August 1983 to August 1984 in Department of Radiology, Chonbuk National University Hospital. The Results were as follows 1. The age distribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59 years(40.9%). 2. The sites of brain infarctiion were cerebral lobes(63cases, 68), basal ganglia(15cases, 16.1%) and multiple sites(6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. The contrast enhancement of acute infarction was noted in 14 ca es(17.5%) which occured commonly between 3 days and 2 weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a. Depression of slow wash-in phase was 20 cases(59%), b. Lower peak concentration was 17 cases(50%), c. Lower and delayed peak concentration was 7 cases(21%), d. No defifite peak concentration was 6 cases(18%). First three patterns of time-density curve were thought as relatively characteristic curve of brain infarction and/or ischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings as hypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entity of dynamic CT scan were as follows: a. large artery thrombotic infarction were 23cases(58%), b. lacunar infarction were 6 cases(15%), c. ischemia were 5 cases(13%), d. normal were 5 cases(13%). In six cases of lacunar infarction which was doubtful hypodensity on per-and postcont ast CT scan had a marked difference in CT #(HU) on absolute scale graph of dynamic CT, so diagnosis of lacunar infarction could be made easily. 7. The clinical values of dynamic CT consist in not only diagnosis of lacunar infarction but also evalution of effectiveness of medical or surgical treatment.treatment.