IMAGING

DIGITAL SUBTRACTION CINE-ANGIOGRAM FOR OSTEONECROSIS OF THE FEMORAL HEAD

Toshihisa Kajiwara, Satoshi Yoshiwara, Yasunari Hiranuma, Jun Toshima, Takashi Atsumi
Department of Orthopaedic Surgery, Fujigaoka Hospital, Showa University School of Medicine, Yokohama Japan

The purpose of this study is to investigate the impairment of the hemodynamics and the revascularization of the non-traumatic osteonecrosis of the femoral head. Superselective angiography of the medial circumflex artery was performed on 20 hips of 18 patients. The subtraction method was employed to provide good visualization using digital subtraction system (PHILIPS Integris V-3000). Erratic hypertrophic superior retinacular arteries were invaded to the demarcated area in 11 hips. Newly formed hypertrophied inferior retinacular arteries were observed in 12 hips and the ligamentum teres arteries were observed in 3 hips. We present here the methods of this examination in details and some interesting cases in VHS. The advantage of using digital subtraction system in superselective angiography of the medial circumflex artery is to achieve good visualization of the revascularization of the femoral head in-vivo in affected hip with the non-traumatic osteonecrosis.