[Postmortem intraosseous phlebography. Anatomical, topographic and hemodynamic problems]

Intraosseous injection of potassium iodide was carried out at the level of the malleolus and the iliac crests in 90 cadavers. Information concerning the anatomy of the veins and concerning different organs was also obtained. We still need to compare this information with that from in vivo phlebography and the results from biopsy. Radiographic films taken at the moment of injection and at various times up to 60 minutes after injection, show the filling not only of the local veins in the lower extremities or the pelvis, but also a flow of contrast material through the abdominal organs and up to the level of the brachio-cephalic veins. Studies on cadavers in the vertical position show little or no difference. We show the filling of the venous system and especially the hepatic and renal veins. Various considerations on the nature of this dynamic effect in the cadaver are discussed, but this will need further study. There are certainly limits of exactitude for this method in comparison with autopsy. The method is not expected to supersede angiography in living patients. It is rather a complementary technique to be used especially in cases where an in vivo angiographic study is lacking or where a biopsy is impossible. In certain cases it is possible to discover radiologically anatomical lesions which are difficult to detect by autopsy or are easily distorted by this procedure.