肺区域血流欠損とその病理所見

抄録

Pulmonary perfusion and ventilation of the patients are studied using radioactive gas Xenon 133 and scintiscanning of the lung which is now widely used for the evaluation of patients with a variety of pulmonary disease. Scintiscanning of the lung is performed after the intravenous injection of macroaggregated albumin ¹³¹I, (¹³¹I-M. A. A.) . The frequency of abnormal scans that cannot be readily explained was found in many patients of pulmonary tuberculosis.
The patients chosen for this study were hospitalized at National Nakano Chest Hospital. This presentation was reported the findings of the lung scan with ¹³¹I-M. A. A. on the small lesions of the pulmonary tuberculosis. Chest films of 500 patients were carefully scrutinize for all abnormalities. The subjects of the lung were small lesions or calcification, which were found opposite side to main lesions. Abnormalities of chest film as changes of pulmonary fibrosis and chronic emphysema were excepted from the subjects. The chest X-rays and scans were examined separately.
7 cases of 500 cases were performed autopsy. 2 cases were excepted from this study. Because main lesion were extend to opposite side in autopsy. The patients were investigated age, % vc and location of the small lesions in the lung. 5 autopsy were examined micrescopically.
In 118 patients with scan abnormalities unexplained by X-ray scan abnormalities were segmental defect and in the scan defect area the small lesions or calcification were found.
Table 2 summarizes the age of the patients and the scan defects, the number of patientss of the scan defects was found equality % in every ages. Table 3 was shown the % vc of the patients. Patients of the scan defects were found moreover % vc 80. Fig 2a was pointed out the location of scan defects. Normal scan with small lesion was shown the Fig 2b. The highest percentage of scan defects was found in the left middle area of the lung.
5 autopsies of scan defects were examined with histological section. Histologic section of of the lungs shows generalized distension of alveoli, pleural thickening and bronchiectasis in the segmental area contained small lesion.
Changes of alveoli in 5 autopsies were diveded 2 major basic anatomical abnormalities according to the causes of diminished perfusion. One of them was atrophy of the alveoli. It is suggested that atrophy of the alveoli is occured by obstruct of the lung circulation. The other of them was the thick alveoli. It is suggested that the thick of alveoli is caused by inflammation of the lung.