title: Prediction of traumatic avascular necrosis of the femoral head by single photon emission computerized tomography and computerized tomography: an experimental study in dogs.
abstract: OBJECTIVE
  To evaluate the femoral head perfusion and to predict the traumatic avascular necrosis (AVN) of the femoral head by single photon emission computerized tomography and computerized tomography (SPECT/CT).
  
  
  METHODS
  Totally 18 adult beagle dogs were divided randomly into three equal-sized (n equal to 6) groups. Subsequently different degrees of ischemia model were developed by destroying blood vessels of the femoral head. The left hip received sham operation as normal control and the right hip underwent blood interruption. In Group A, the ligamentum teres was cut off. In Group B, the marrow cavity of the right femoral neck was destroyed while in Group C, the soft tissues at the base of the femoral neck were stripped in addition to the resection of the ligamentum teres and destruction of the marrow cavity. Three hours after surgery, SPECT/CT was performed. Laser Doppler Flowmetry (LDF) measurements were also obtained at three different time points (before operation, immediately and three hours after operation) in order to assess the change process of blood supply to the femoral head.
  
  
  RESULTS
  SPECT/CT showed no significant difference in the radionuclide uptake between the right and left femoral heads in Group A (t equal to -0.09, P equal to 0.94) and Group B (t equal to 0.52, P equal to 0.62). However, in Group C, it was 261+/-62 for the right femoral head, only 12% of that in the left femoral head. LDF measurements indicated that the femoral head perfusion was decreased from (45.0+/-3.3) PU to (39.1+/-3.7) PU in Group A,from (44.0+/-2.7) PU to (34.3+/-2.6) PU in Group B, and from (47.3+/-2.1) PU to (4.96+/-0.6) PU in Group C immediately after operation. However, the perfusion was restored and returned to normal values three hours after operation except in Group C.
  
  
  CONCLUSIONS
  SPECT/CT could assess the perfusion of the femoral head semiquantitatively, which might be useful in predicting the development of traumatic AVN.
authors.affiliation: Department of Orthopaedics, Zhongshan Hospital of Fudan University, Shanghai 200032, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Shen
authors.forename: Zuo-Qin
authors.initials: ZQ
authors.lastname: Yan
authors.forename: Chang-An
authors.initials: CA
authors.lastname: Guo
authors.forename: Hong-Cheng
authors.initials: HC
authors.lastname: Shi
authors.forename: Yu-Shen
authors.initials: YS
authors.lastname: Gu
authors.forename: Meng-Su
authors.initials: MS
authors.lastname: Zeng
authors.forename: Xiao-Yu
authors.initials: XY
authors.lastname: Lu
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
mesh_terms: D000818:Animals; D004285:Dogs; D005270:Femur Head; D005271:Femur Head Necrosis; D015899:Tomography, Emission-Computed, Single-Photon