18F-FDG PET/CT in the Diagnosis of Post-Traumatic Osteomyelitis
10.3969/j.issn.1005-5185.2024.12.014
- VernacularTitle:18F-FDG PET/CT对创伤后骨髓炎的诊断价值
- Author:
Fang YANG
1
;
Yuyi ZHANG
1
;
Jin FENG
1
;
Lianna ZHANG
1
;
Xuan GAO
1
;
Ziwei CHEN
1
Author Information
1. 首都医科大学附属北京积水潭医院核医学科,北京 100035
- Publication Type:Journal Article
- Keywords:
Osteomyelitis;
Wounds and injuries;
Positron-emission tomography;
Tomography,X-ray computed;
Fluorodeoxyglucose F18;
Infections
- From:
Chinese Journal of Medical Imaging
2024;32(12):1266-1271
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the 18F-FDG PET/CT metabolic characteristics and the accuracy of diagnosis in post-traumatic osteomyelitis. Materials and Methods A total of 64 patients with post-traumatic fracture nonunion and suspected infection in Beijing Jishuitan Hospital were retrospectively analyzed. The PET/CT examinations were performed from May 2019 to April 2020. Qualitative and semi-quantitative evaluation methods were used to evaluate the diagnostic accuracy of 18F-FDG PET/CT in post-traumatic osteomyelitis. The diagnostic efficiency was compared among different laboratory indexes,such as erythrocyte sedimentation rate,C-reactive protein and leukocyte. Logistic regression was used to analyze parameters with diagnostic significance. Results Among 64 patients with post-traumatic fracture nonunion,37 were ultimately diagnosed with post-traumatic osteomyelitis. Among them,23 were confirmed through positive microbial cultures during surgery,and 14 were diagnosed based on clinical symptoms and follow-up results. The remaining 27 patients showed no signs of infection based on intraoperative microbial cultures (n=10) or clinical follow-up of more than six months (n=17). PET/CT correctly identified infections in 34 of the 37 infected cases and accurately ruled out infections in 23 of the 27 non-infected cases. The sensitivity,specificity,positive predictive value,negative predictive value and overall diagnostic accuracy of PET/CT were 91.89％,85.19％,89.47％,88.46％ and 89.06％,respectively. The maximum standardized uptake value (SUVmax) of PET/CT semi-quantitative parameter in the infection group (6.23±2.16) was higher than that in the non-infection group (4.24±1.86),showing a statistically significant difference (t=3.864,P<0.01). Logistic regression analysis revealed that SUVmax and C-reactive protein had diagnostic significance for distinguishing between groups,and SUVmax demonstrated higher diagnostic accuracy than C-reactive protein (x2=27.245,P<0.001). Conclusion The metabolic imaging features provided by 18F-FDG PET/CT imaging help to provide a more accurate reference for the diagnosis of post-traumatic osteomyelitis,which is worthy of clinical application.
