The Study Of ANFH Patient’s DSA Vascular Morphology And Bone Necrosis Hardening Of The Correlation

ObjectiveStudy of patients with femoral head necrosis femoral head the correlation between the DSA manifestations of vascular and necrosis of bone sclerosis, to know if can rely on simple X-ray to diagnosis and predict the development of avascular necrosis of the femoral head.Avascular necrosis of the femoral head are cl inical frequently-occurring disease and the common disease, current treatment is a difficult problem in the world. Mostly occurs in younger, without effective treatment, approximately80%in1-4years will progress to the collapse of femoral head and the function of joint damage. Most of the patients had to artificial joint replacement, but in the current level, the younger’s artificial joint replacement in the long-term effective remains difficult to predict therefore, seeking to preserve the patient’s own joint effective treatment is necessary. The blood circulation disorder of femoral head is the core problem. Study of the femoral head and neck vascular morphology, improve the blood supply to the femoral head for the treatment of femoral head necrosis is one of the important methods. Femoral head blood vessel imaging studies including CTA (CT angiography), CE-MRA (enhanced magnetic resonance angiography), DSA (digital subtraction angiography), one of the most direct the most accurate means of digital subtraction angiography (Digital subtraction angiography DSA), DSA technology can be used in the course of treatment with the naked eye to directly observe the avascular of necrotic area surrounding and dyeing conditions, complete and clear understanding of ischemia of the femoral head blood supply pattern, is recognized as the" gold standard vascular imaging". Although the accuracy was superior to other current vascular checking method, but as an invasive test, high cost, complicated operation, check the risk is relatively large. At present, X-ray is avascular necrosis of the femoral head in the most convenient the most basic examination method, X-ray although sensitivity is low, but have curtain accuracy, most patients can be diagnosed by X-ray, and X-ray is Avascular necrosis of the femoral head in review the most economic method. Therefore, research on DSA of femoral head blood supplying and vascular necrosis of femoral head necrosis of X-ray correlations, rely on X-ray for avascular necrosis of the femoral head for efficacy assessment, periodic review and clinical follow-up treatment plan has important guiding significance.MethodsBy using Fang Dou medical imaging system comes with software and AUTOCAD (computer aided mapping software) to calculate the area of irregular figure, were seperately measured the zone in therapy within two weeks X-ray of necrosis of femoral head hardened and necrosis total area and necrosis area, subtract that hardening of the area, then calculate the hardening area and the necrosis area ratio, according to the size and area ratio respectively for rank.To comply with the standard digital subtraction angiography, analysis, record; key indicators include:a mainly for observation of femoral artery on the support belt, upper epiphysis of artery and the lateral epiphysis of artery, main branches of Inferior support belt artery. Inferior epiphysis artery the shape.according to Trueta standard, combine me through a lot of femoral head blood supply and vascular anatomy of the more than400cases of the femoral head blood supply DSA with improved performance, The femoral head blood supply base is1points, medial femoral cirumflex artery total3points, respectively, upper epiphysis of artery and the lateral epiphysis of artery and Inferior epiphysis artery. Lateral femoral circumflex artery ascending branch through the support artery into the femoral head zone is1points, then the vessel in accordance with the self-made standards on180hip joint score (1to5points), According to the blood vessels supplying the degree, According to the hierarchical layout order.On180cases collected into the case of the above information, create database, using the Spearman rank correlation (rank correlation), also known as the rank correlation, calculating a difference between the correlation coefficient, determine the femoral head blood supply and X-ray hardening and necrosis ratios of these two grade variables associated with the degree of orientation.ResultsThrough the Spearman rank correlation analysis to know, X-ray reflect the necrosis and hardened zone area with the vascular extent have slightly negative correlation; area of necrosis with the vascular extent also showed a slightly correlation.ConclusionAvascular necrosis of the femoral head with digital subtraction angiography, can react with the femoral head blood supply., Blood supply of the femoral head with necrosis and hardening of the area ratio between negative slightly negative correlation. Digital subtraction angiography as reflected between the blood supply to the femoral head avascular necrosis of the femoral head area have slightly negative correlation. To some extent, can rely on the X ray to roughly Judgment of avascular necrosis of the femoral head development and prognosis.