酵素拡散剤を応用した上顎嚢胞性疾患の X 線造影法の改良に関する研究

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The diagnosis of any cyst or cystlike lesion depends on the clinical examination, history and radiography interpretation. The radiography is of paramount importance in the identification of these cysts. It gives evidence of abnormalities of the bone structure and discloses changes in their architecture and alteration in their radioabiity, but x-ray examination of the upper jaw presents unusual difficulties because of its complicated structure adjacent to the bones, such bones as foramina, the roots of the teeth, the nasal cavity, the accesory sinus, processes, cervical vertebrae which duplicate one another, are not easily examined by the x-ray flat picture in many projections, for instance, occipito-frontal, occipito-mental projection, and orthopantomography. In cases of the maxillary cyst, especially the postoperative created cyst or empyem in which the differentiation of a cystic cavity from the maxillary sinus is not clearly demonstrable in a flat x-ray picture, contrast media were injected into the lesion. The media help to differentiate them from tumor, to demonstrate the size, and to visualize if the maxillary sinus is invaded. The following contrast media were used for the investigation of 41 patients in 43 cases : (1) 40% Moljodol. (2) 76% Urografin. (3) Conray 400. (4) Hytrast. The above contrast media were used in the following three contrast methods : (1) Simple contrast method. (2) Double Contrast method. (3) Reformed double contrast method. These were used in taking picture of the posteroanterior, Water's and oblique (Cies-zynski's method) projection, and of orthopantomography. Before the contrast media were injected into the lesion, the pus were discharged and emptied by puncture, and the lesion was irrigated with saline water. In the reformed double contrast method after emptying the contents and irrigation, hyaluronidase (injected solution, 400 units) was used to irrigate the lesion again to absorb and adhere the membrane and expedite the contrastgraphy. The conclusion was as follows : (1). The x-ray flat picture is difficult to visualize because of its complicated structure adjacent to bones. (2). The simple contrast method is fit for observation in morphologic plane structure, but not fit nor meaningful in analysis of stereography observation. (3). The application of orthopantomography in simple contrast is possible to observe in stereography, especially to interprete the various adjacent tissue of maxillary tuber-rosity. (4). The adjacent tissue of the lesion which could not be interpreted in flat and simple contrastgraphy were possible to observe in double contrastgraphy, in which the contrast medium, adhered in the membrane surface, was shown as a thin matting layer. (5). After application of the double contrast method, some bubbles and insufficiency of adherence of contrast media were observed, but it has been certified that the his-tologic cyst tissue does not influence the above various factors. (6). Reformed double contrast method which employs hyaluronidase for irrigation of lesion made effectiveness of roentgenogram much higher than previously possible.
九州歯科学会の論文
1973-09-30

酵素拡散剤を応用した上顎嚢胞性疾患の X 線造影法の改良に関する研究

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