<sup>18</sup>F-FDG PET/CT对下肢开放骨折术后感染的定位诊断价值及引导作用

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Abstract Objective To evaluate the applicability of ¹⁸F-FDG PET/CT in the positional diagnosis of postoperative infections of open fractures in lower extremities, and its role in debridement surgery.Methods Fifteen patients with suspected chronic local infections following surgeries for traumatic fractures of lower extremities were recruited between July 2018 and June 2019. PET/CT examination was performed one week before debridement. Infection lesions were positioned according to PET/CT images and compared with results of postoperative pathology, microbial culture and PET/CT. The mean SUVmax of bone infections and soft tissue infections was calculated, while the findings of PET/CT and SPECT/CT imaging of one patient were analyzed. The effect of PET/CT-guided debridement was assessed.Results Among the 15 patients, 6 had simple bone infection lesions, 3 had simple soft tissue infection lesions, and the other 6 patients had both bone infection lesions and soft tissue infection lesions. A total of 18 bone infection lesions and 12 soft tissue infection lesions were found by PET/CT. The SUVmax of bone infection lesions was 5.1±3.4, compared with 3.6±2.4 for soft tissue infection lesions. The diagnostic sensitivity of PET/CT for bone infections and soft tissue infections was 94.4% and 83.3% respectively. The sensitivity of PET/CT was higher than that of SPECT/CT imaging. Under the guidance of PET/CT, the cure rate of patients with open fractures in lower extremities after one debridement was 93.3% (14/15).Conclusions The accuracy of ¹⁸F-FDG PET/CT in the diagnosis of postoperative infections of open fractures of lower extremities is high, and the effect of guided debridement is reliable.

Key words： open fracture infection PET/CT deoxyglucose debridement

Received: 10 June 2020

ZTFLH:	R817.4
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	Articles by authors
	YIN Liang
	YUE Jianlan
	HUANG Shiming
	ZHANG Qing
	LIU Fei
	WANG Qiuju
	Lin Zhichun

Cite this article:

YIN Liang,YUE Jianlan,HUANG Shiming等. Applicability of ¹⁸F-FDG PET/CT in patients with suspected local infection after open fractures of lower extremity[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(2): 128-131.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2021/V32/I2/128

[1]	Groznik M, Cimerman M, Lusa L, et al. Increased perioperative C-reactive protein and decreased postoperative albumin is associated with acute posttraumatic osteomyelitis in patients with high-energy tibial fractures[J].Injury, 2019, 50(4): 827-833.
[2]	Govaert G A, Kuehl R, Atkins B L, et al. Diagnosing fracture-related infection: current concepts and recommendations[J].J Orthop Trauma, 2020, 34(1): 8-17.
[3]	Metsemakers W J, Morgenstern M, Senneville E, et al. General treatment principles for fracture-related infection: recommendations from an international expert group[J].Arch Orthop Trauma Surg, 2020, 140(8): 1013-1027.
[4]	Glaudemans A W, Jutte P C, Cataldo M A, et al. Consensus document for the diagnosis of peripheral bone infection in adults: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement)?[J].Eur J Nucl Med Mol Imaging, 2019, 46(4): 957-970.
[5]	Govaert G A, Glaudemans A W, Ploegmakers J J, et al. Diagnostic strategies for posttraumatic osteomyelitis: a survey amongst Dutch medical specialists demonstrates the need for a consensus protocol[J].Eur J Trauma Emerg Surg, 2018, 44(3): 417-426.
[6]	Harris J C, Caesar D H, Davison C, et al. How useful are laboratory investigations in the emergency department evaluation of possible osteomyelitis? [J].Emerg Med Australas, 2011, 23(3): 317-330.
[7]	Govaert G A, Bosch P, Ijpma F A, et al. High diagnostic accuracy of white blood cell scintigraphy for fracture related infections: results of a large retrospective single-center study[J].Injury, 2018, 49(6): 1085-1090.
[8]	刘玉珂, 李培岭, 郭会利, 等. SPECT/CT融合骨显像评价四肢骨折远期愈合[J]. 中国医学影像技术, 2018, 34(5): 751-753.
[9]	杨芳, 张连娜, 冯瑾, 等. 三相骨显像对创伤后感染性骨折愈合不良的诊断价值[J]. 中国医学影像学杂志, 2013, 21(2): 110-113.
[10]	Zhang Q, Dong J, Shen Y, et al. Comparative diagnostic accuracy of respective nuclear imaging for suspected fracture related infection: a systematic review and Bayesian network meta-analysis[J].Arch Orthop Trauma Surg,2020:20.[published online ahead of print, 2020 Jun 8]
[11]	Sollini M, Trenti N, Malagoli E, et al. 18F-FDG PET/CT in non-un-ion: improving the diagnostic performances by using both PET and CT criteria[J].Eur J Nucl Med Mol Imaging, 2019, 46(8): 1605-1615.
[12]	Wenter V, Müller J P, Albert N L, et al. The diagnostic value of 18F FDG PET for the detection of chronic osteomyelitis and implant-associated infection[J].Eur J Nucl Med Mol Imaging, 2016, 43(4): 749-761.
[13]	Demirev A, Weijers R, Geurts J, et al. Comparison of 18 F FDG PET/CT and MRI in the diagnosis of active osteomyelitis[J].Skeletal Radiol, 2014, 43(5): 665-672.
[14]	Lemans J V C, Hobbelink M G G, IJpma F F A, et al. The diagnostic accuracy of 18F-FDG PET/CT in diagnosing fracture-related infections[J].Eur J Nucl Med Mol Imaging, 2019, 46(4): 999-1008.
[15]	Vliet K E, Jong V M, Termaat M F, et al. FDG-PET/CT for differentiating between aseptic and septic delayed union in the lower extremity[J]. Arch Orthop Trauma Surg, 2018, 138(2): 189-194.
[16]	任方远, 左长京, 汪建华, 等. 18F-FDG PET/CT在主动脉腔内修复术后血管移植物感染诊断中的应用[J]. 中华核医学与分子影像杂志, 2019, 39(3): 138-141.