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뇌동맥류파열의 전자화단층촬영 및 혈관조영 소견
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  • 뇌동맥류파열의 전자화단층촬영 및 혈관조영 소견
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김정식
간행물명
대한방사선의학회지
권/호정보
1984년|20권 3호|pp.430-439 (10 pages)
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대한영상의학회
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
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CT has become one of the most important diagnostic method in the evaluation of ruptured intracranial aneurysm with direct detection of subarachnoid, intracerebral and intraventricular hemorrhage. and identification of complications such as recurrent bleeding, hydrocephalus and infarction secondary to arterial spasm. Angiography gives precise information on the location, size of aneurysm and presence of arterial spasm. Authors attempted to predict the location of reptured aneurysm in the CT by distribution of blood in subarachnoid spaces and brain parenchyme in comparison with angiographic findings, and also predict the prognosis of the patients by relationship between the extent of blood and clinical grade. Authors analysed 40 cases of ruptured intracranial aneurysm confirmed by CT and angiography at Keimyung Untversity Hospital for last 2 years. The results were as follows: 1. The age and sex distribution ; the most prevalent age group was 5 th to 6th decades (70%), and female patient was slightly more than male patient (57.5%:42.5%). 2. The location of aneurysms were; posterior communicating artery group 17 cases (42.2%), middle cerebral artery group 10 cases (25.0%), anterior communicating artery group 7 cases (17.5%), basilar artery bifucation 1 cases (2.5%), posterior inferior cerebellar artery 1 case (2.5%), and multiple aneurysms 4 cases (10%) in order to frequency. 3. Characteristic distributions of intracranial hemorrhage in CT were as follows; 1) In 6 cases (85.7%) of anterior communicating artery aneurysm, interhemispheric fissure hemorrhage was noted. 2) The ipsilateral sylvian fissure hemorrhage was noted in all cases of middle cerebral artery aneurysm (10 cases) and 12 cases (70.6%) of posterior communicating artery aneurysm. 3) Localized hematoma in frontal lobe near interhemispheric fissure (2 cases : 28.6%), septum pellucidum (1 case:14.3%) and corpus callosum (1 case:14.5%) were characteristic in anterior communicating artery aneurysm. 4) Commashaped sylvian fissure hematoma (5 cases:50%) and temporal lobe hematoma near sylvian fissure (5 cases :50%) may indicate middle cerebral artery aneurysm. 5) Intraventricular hemorrhage (6 cases :15%) has no particular predilection of aneurysmal location. 4. In 9 paients (22.5%) of clinically suggesting subarachnoid hemorrhage, no extravasated blood was noted in preenhancement CT alone. 5. Six cases (15%) showed aneurysm itself on preenhancement CT as a round or ovoid hyperdense area or isodense area with mass effect such as cisternal obliteration. 6. Hydrocephalus was noted in 9 cases (22.5%) 7. there was no direct correlation between the size of the intracranial aneurysm and extent of the hemorrhage in CT, and between the size of the intracranial aneurysm and clinical grade. 8. There was direct correlation between the extent of blood in CT and clinical grade.