CLINICAL USEFULNESS OF ROTATIONAL DIGITAL ANGIOGRAPHY IN THE DIAGNOSIS AND INTERVENTION OF SEVERE PELVIC FRACTURES.

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Rotational digital angiography using a computerized dynamic stereo-angiography apparatus is a newly developed digital system. An X-ray tube, a high resolution image intensifier and an X-ray TV camera are installed linearly in the gantry, and they rotate transversely around the patient> 360 degrees at a speed of 4.8 sec. During the rotation, pulse exposure is done at every 1.25 degrees by computer control, so that 288 different projectional images can be acquired following just a single injection of contrast medium. These images are displayed via the real time digital processing on a cathode ray tube. Subtraction mode is automatically carried out on all images. The purpose of this study was to clarify the clinical significance of rotational digital angiography in the diagnosis and intervention of severe pelvic fractures. Subjects were the hemodynamically unstable patients with severe pelvic ring fractures. CT,conventional digital subtraction angiography, and rotational digital angiograp … More hy were performed. Transcatheter arterial embolization were needed for the control of severe retroperitoneal hemorrhage in all patients.The assessements were as followed ;1. Comparison between abnormal angiograpic findings and fracture sites on CT.2. Comparison between abnormal angiographic findings and volume of retroperitone al hematomas on CT.The results were as followed :1. There was a descrepancy between the angiographic findings and fracture sites. Angiographic abnormalities without fracture were seen especially in the lateral sacral artery and iliolumbar artery.2. There was a descrepancy between the angiographic findings and retroperitoneal hematomas. Retroperitoneal hematomas, especially around the ilium, were seen on CT in the absence of any abnormal angiographic findings.3. Angiographic extravasation without hematoma on CTwas seen especially in lateral sacral artery.4. Rotational digital angiography was useful for the detection and evaluation of extravasation of contrast medium. Less