{"id":202,"date":"2012-04-19T03:00:46","date_gmt":"2012-04-18T18:00:46","guid":{"rendered":"\/sawamura\/wp\/?p=202"},"modified":"2016-08-20T09:23:41","modified_gmt":"2016-08-20T00:23:41","slug":"endoscopicbiopsy","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/surgtech\/endoscopicbiopsy\/","title":{"rendered":"\u5185\u8996\u93e1\u751f\u691c\u8853"},"content":{"rendered":"
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\u5185\u8996\u93e1\u306b\u3088\u308b\u7b2c3\u8133\u5ba4\u958b\u7a93\u8853\u3068\u751f\u691c\u8853<\/h1>\n

\u677e\u679c\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u7b2c3\u8133\u5ba4\u958b\u7a93\u8853\u3068\u5185\u8996\u93e1\u751f\u691c\u306e\u30d3\u30c7\u30aa\u3067\u3059\uff0c\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u898b\u3048\u307e\u3059\uff08YouTube\u306e\u753b\u9762\u304c\u65b0\u305f\u306b\u958b\u304d\u307e\u3059 3\u520646\u79d2\uff09<\/a><\/span><\/h5>\n

\u53f3\u306e\u5074\u8133\u5ba4\u304b\u3089\u5165\u3063\u3066\uff0c\u53f3\u306e\u5074\u8133\u5ba4\u306e\u5916\u5074\u58c1\u3092\u89b3\u5bdf\u3057\u307e\u3057\u305f\u3002\u7121\u6570\u306e\u5c0f\u7d50\u7bc0\u7528\u306e\u5c0f\u3055\u306a\u9686\u8d77\u304c\u8133\u5ba4\u58c1\u306b\u89b3\u5bdf\u3055\u308c\u307e\u3059\u3002\u3053\u308c\u306f3-tesla MRI\u3067\u3082\u63cf\u51fa\u3067\u304d\u306a\u3044\u3082\u306e\u3067\u3059\u304c\uff0cgerminoma\u3092\u5185\u8996\u93e1\u89b3\u5bdf\u3059\u308b\u3068\u9ad8\u7387\u306b\u898b\u3089\u308c\u308b\u6240\u898b\u3067\u3059\u3002subependymal infiltration\u3068\u3044\u3063\u3066\uff0cCSF seeding (dissemination)\u3068\u306f\u7570\u306a\u308a\u307e\u3059\u3002\u3042\u304f\u307e\u3067\u3082\u5c40\u6240\u6d78\u6f64\u306a\u306e\u3067\u3059\u3002
\n\u6b21\u3044\u3067\uff0c\u4e73\u982d\u4f53 mamillary bodies \u306e\u524d\uff0c\u7070\u767d\u9686\u8d77 tuber cinereum \u306e\u5f8c\u65b9\u3067\u8584\u304f\u306a\u3063\u305f\u7b2c3\u8133\u5ba4\u5e8a\u306b\u958b\u7a93\u8853\u3092\u884c\u3044\u307e\u3059\u3002\u4e21\u5074\u306e\u4e73\u982d\u4f53\u306f\u4e38\u3044\u5f62\u3067\u306f\u3063\u304d\u308a\u898b\u3048\u3066\u3044\u307e\u3059\u3002\u534a\u900f\u660e\u306b\u306a\u3063\u305f\u90e8\u5206\u304b\u3089\u88cf\u5074\u306e\u8133\u5e95\u52d5\u8108\u3068\u305d\u306e\u5206\u679d\u304c\u307f\u3048\u308b\u304b\u3089\u30e2\u30ce\u30dd\u30fc\u30e9\u3067\u3082\u5b89\u5168\u306b\u5207\u958b\u3067\u304d\u3066\u3044\u307e\u3059\u3002\u3067\u3082\uff0c\u7b2c3\u8133\u5ba4\u5e8a\u306b\u900f\u898b\u6027\u304c\u306a\u3044\u5834\u5408\u306b\u306f\u3068\u3066\u3082\u5371\u967a\u3067\uff0c\u7279\u306b\u8133\u5e95\u52d5\u8108\u304b\u3089\u306e\u7a7f\u901a\u52d5\u8108\u304c\u3053\u306e\u88cf\u5074\u306b\u63a5\u3057\u3066\u3044\u308b\u5834\u5408\u306b\u306f\uff0c\u640d\u50b7\u3059\u308b\u3068\u6b62\u8840\u306f\u6975\u3081\u3066\u56f0\u96e3\u3067\u3042\u308b\u3068\u8003\u3048\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002lethal complicaiton\u306b\u306a\u308a\u307e\u3059\u3002\u30e2\u30ce\u30dd\u30fc\u30e9\u5207\u958b\u306e\u4e0a\u624b\u306a\u4f7f\u3044\u65b9\u306f\uff0c\u51fa\u529b\u3092o\u304b\u3089\u59cb\u3081\u3066\uff0c1, 2, 3, 4, 5, – – -\u3068\u5f90\u3005\u306b\u6709\u52b9\u3067\u3042\u308b\u6700\u4f4e\u9650\u306e\u30ec\u30d9\u30eb\u307e\u3067\u6f38\u5897\u5e45\u3059\u308b\u3053\u3068\u3067\u3059\u3002\u3044\u304d\u306a\u308a\u5f37\u3044\u5207\u958b\u306b\u3059\u308b\u3068\u8840\u7ba1\u640d\u50b7\u3092\u751f\u3058\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u958b\u3051\u305f\u5b54\u3092\u9257\u5b50\u3067\u5e83\u3052\u3066\u3044\u307e\u3059\u304c\uff0c\u30d0\u30eb\u30fc\u30f3\u3067\u62e1\u5927\u3059\u308b\u65b9\u304c\u4e00\u822c\u7684\u3067\u3057\u3087\u3046\u3002
\n\u6b21\u3044\u3067\uff0c\u677e\u679c\u4f53\u90e8\u816b\u760d\u304b\u3089\u306e\u751f\u691c\u8853\u3092\u884c\u3063\u3066\u3044\u307e\u3059\u3002\u3082\u3061\u308d\u3093\u80da\u7d30\u80de\u816b\u760d\u306f\u51fa\u8840\u6027\u306e\u3082\u306e\u304c\u591a\u3044\u306e\u3067\uff0c\u7121\u7406\u306f\u3057\u307e\u305b\u3093\u3002\u5947\u5f62\u816b\u306f\u786c\u304f\u3066\u816b\u760d\u7247\u304c\u3061\u304e\u308c\u306a\u3044\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u305d\u306e\u6642\u3082\u7121\u7406\u3092\u3057\u307e\u305b\u3093\u3002\u5185\u8996\u93e1\u624b\u8853\u306f\u5408\u4f75\u75c7\u306a\u304f\u7d42\u308f\u308c\u3070\u6210\u529f\u3067\u3059\uff0c\u4f8b\u3048\u751f\u691c\u306b\u5931\u6557\u3057\u3066\u3082\u305d\u308c\u3067\u3044\u3044\u306e\u3067\u3059\u3002\u8853\u524d\u306b\u5185\u8996\u93e1\u624b\u8853\u3067\u306f\u30ea\u30b9\u30af\u3092\u53d6\u308c\u306a\u3044\u3053\u3068\u3092\u60a3\u8005\u3055\u3093\u306b\u3088\u304f\u8aac\u660e\u3057\u307e\u3057\u3087\u3046\u3002<\/p>\n

\n

endoscopic third ventriculostomy and
\nbiopsy for pineal germinoma<\/a> (click here)<\/a><\/h2>\n

Peroperative view during endoscopic surgery in a boy with neurohypophyseal and pineal germinoma. There are numerous tiny nodules on the wall of right lateral ventricle. These lesions are neither tumor CSF seeding nor dissemination. Germinoma cells always invades into subependymal glial tissue and spread to the whole ventricular system including the ovex. This has been called as subependymal infiltration (extension) of germinoma. Third ventriculostomy at the tuber cinereum in front of the mammillary bodies and tumor biopsy at the pineal lesion were shown.<\/p>\n

\n

presurgical images<\/h2>\n

\"\"<\/a> \"\"<\/a>
\nA 12-year-old boy had polydipsia and polyuria for several months, then he frequently complained general fatigue. Gadolinium-contrasted images (left; T1 sagittal, right; CISS coronal) depicted neurohypophyseal and pineal tumors, and obstructive hydrocephalus, but not any lesions on in the lateral ventricle.
\n\"\"<\/a> \"\"<\/a>
\n3-teslar MRI also faild to show any lesions on the wall of ventricles, however endoscopic observation revealed numerous ventricle-wall nodules (as shown in VIdeo).<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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