筋萎縮性側索硬化症の頸髄肉眼的形態変化について : 造影CT像と病理標本像との比較   :   The CervicalCord in Amyotrophic Lateral Sclerosis : A Comparison of the CT-myelography with Pathological Observation. 

作成者 菅宮, 斉, 得丸, 幸夫, 新井, 公人, 平山, 惠造
作成者の別表記 スガミヤ, ヒトシ, SUGAYA, Hitoshi, トクマル, ユキオ, TOKUMARU, Yukio, アライ, キミヒト, ARAI, Kimihito, ヒラヤマ, ケイゾウ, HIRAYAMA, Keizo
キーワード等 Amyotrophic lateral sclerosis, CT-myelography, Autopsied specimen, Cervical cord flattening, Concave of posterolateral fissure
日本十進分類法 (NDC) 490
内容 病理学的に確診された筋萎縮性側索硬化症5例における頸髄肉眼的形態変化を生前の造形CT像と剖検による病理標本像とで比較検討した。造形CT像は病理標本像とともに以下の特徴を有した。(1)全経過1年未満の2例では造影CT像と病理標本像の両者において肉眼的形態変化の異常は認められなかった。(2)全経過1年以上の3例では造影CT像と病理標本像の両者とも頸髄の扁平化あるいは後外側溝部の陥凹などの肉眼的形態変化を認め, 下位レベルほど強く, 上肢筋萎縮, 下肢錐体路徴候の強い症例ほど著明であった。臨床症状の左右差は肉眼的形態変化としてはとらえられなかった。以上から, 本症の造影CT像はその病理像を反映して頸髄の扁平化と後外側溝部の陥凹を呈しうるが, 経過の長短を考慮すべきものと思われた。
The spinal cord with amyotrophic lateral sclerosis was macroscopically examined in five patients using CT-myelography (CTM) and autopsied specimens. The autopsied ages were from 48 to 75 years old (average: 64), and their clinical follow-up periods were from 0.8 to 4.0 years (average: 1.9). Muscular atrophy developed from an upper limb in three patients, whereas from a lower limb in one case and from bulbar muscles in another case. Cervical CTM was performed at C3 to C7 cervical vertebrae less than one year (four cases) and 1.9 years (one case) prior to autopsy. The macroscopical examination of the CTM and autopsied specimens showed the following characteristics: Two patients, whose clinical courses were less than one year from the onset, showed no abnormalities. Three patients, whose clinical courses were more than one year from the onset, showed a marked cervical flattening and concave of the posterolateral fisure, especially at the lower cervical level. It was supposed that this lower cervical abnormalities caused pronounced amyotrophy in the upper limbs and pyramidal tract sign of the lower limbs. Although muscular atrophy was asymmetric in one case, the spinal cord was symmetric in macroscopic appearence in both CTM and autopsied specimens. It was concluded that marked flattening and concave at the posterolateral fissure of the lower cervical spinal cord were revealed by CTM in patients whose clinical courses of amyotrophic lateral sclerosis were more than one year from the onset.

公開者の別表記 千葉医学会
コンテンツの種類 雑誌掲載論文 Journal Article
ファイル形式 application/pdf
ISSN 0303-5476
NCID AN00142148
掲載誌情報 千葉医学雑誌 Vol.71 no.4 page.281-286 (19950801)
情報源 Chiba medical journal
言語 日本語
著者版フラグ publisher

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