股骨头缺血性坏死血管造影及血供初步研究

目的 研究股骨头缺血性坏死(ANFH)血管造影表现和血供特点。方法 回顾分析经临床和影像学检查确诊并经介入治疗的165例214个髋部血管造影资料，与21例21个正常髋对照观察。结果 旋股内动脉及其分支异常为主伴有或不伴有其他血管异常者162例(2ll髋)，占98．6％。ANFH血管造影表现：①旋股内动脉头上支、头下支尤其是上支持带动脉异常；②旋股外动脉升支分支异常；②股骨头、颈部实质期染色；④坏死区周围细小动脉再血管化；⑤侧支循环增加；⑥静脉回流异常。结论 ANFH血供异常主要发生在旋股内动脉及其分支区域，部分伴有静脉回流异常；血管造影和DSA能反映ANFH的血管形态学变化。

Superselective angiographic findings and the blood supply in the cases of avascular necrosis of the femoral head: a preliminary study

Objective To study the superselective angiographic findings and blood supply in the case of avascular necrosis of the femoral head (ANFH). Methods One hundred and sixty five patients(214 hips) with ANFH proved by clinic and radiology underwent superselective angiography of the hips and interventional therapy, while 21 normal hips were selected as the control group. Superselective angiography and DSA findings were retrospectively studied. Results Abnormal angiographic findings of the medial circumflex artery and its branches, with or without other abnormal vascularities, could be obtained in 162 hips out of 211(98.6%). Angiographic findings of ANFH were the followings: abnormal superior and inferior capsular branch of the medial circumflex artery, especially the former one; abnormalities in the ascending branch of lateral circumflex artery; opacification of the femoral head and neck in the parenchymal phase of DSA; revasculization of the small arterial branches or a hypervascular area surrounding the necrotic lesions; anastomosis between the medial circumflex artery and the inferior and superior gluteal arteries; and the venous stasis. Conclusion Morphological changes of blood vessels in ANFH are demonstrated by superselective angiography, in which the medial circumflex artery and its branches are mostly involved, or in some cases, accompanied by venous stasis.