The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA--after pedicled pelvic bone graft--revealed a regular arterial graft perfusion in 82%.
In this prospective study 39 patients with malignant liver tumours were examined by rapid CT. CT was performed before contrast, as dynamic CT, with and without table movement and, in some patients, images were obtained four hours after contrast injection. Time/density curves of hepato-cellular carcinomas (nine cases) showed more rapid and more intense enhancement of the tumour than of the liver parenchyma, whereas tumours of biliary origin (ten cases) showed a slower and less marked enhancement than surrounding tissue. In addition, it was possible to differentiate hypovascular metastases (18 cases) and hypervascular lesions by means of the time-density curve. Best diagnostic information was obtained by dynamic bolus CT. This method without table movement is best for differentiating focal lesions, whereas dynamic CT with table movement shows the extent and number of tumour lesions.
In 25 patients in whom oral surgery was required, we examined what additional information can be obtained via three-dimensional CT compared with conventional transverse CT scans. We showed that D-3 CT facilitated the spatial orientation by complex osseous destructions. Better therapy planning and postoperative control was therefore feasible. However, CT diagnosis continued to be based on transverse scans.
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