泌尿器科領域における骨盤内動脈撮影法に関する研究

Abstract

Forty-six retrograde pelvic arteriographies were performed without catheter. The femoral artery was punctured, a tourniquet was applied to block the arterial supply to the lower extremity, and 40 m1 of the contrast material was rapidly injected for radiography. The above method was first proved to be safe on the experimental animals, dogs and rabbits. 1) In 80 %, successful arteriograms were taken. No serious untoward effects were observed. In majority of cases, lumbar pain was complained at the time of injection of the contrast material because only local anesthesia was employed. 2) In bladder tumor, classification by stage was made possible with use of the serial radiographic apparatus; and the helpful informations were obtained as to diagnosis and treatment. 3) In prostatic hypertrophy, the prostatic angle, the angle on radiogram between the inferior vesical and middle rectal artery, was measured with relation to the weight of surgically removed adenoma. When the weight of one lobe was less than 10 gm, 10 to 20 gm, and over 20 gm ; the angle was 45 to 60, 60 to 90, and over 90 degree respectively. 4) In carcinoma of the prostate, turtuosity of the periprostatic arteries made the measurement of the angle impossible. 5) In experimental animals, changes in intraaortic pressure and pulse rate at the time of pelvic arteriography were observed. Some noticeable changes were recorded when the amount of injected contrast material was 1 ml per kg body weight but no changes when 0.5 ml was injected. 6) Retrograde pelvic arteriography of the author's method was proved to be simple and satisfactory enough to be clinically performed for differential diagnosis of intrapelvic diseases.