Radionuclide imaging of the painful hip arthroplasty
Radionuclide imaging of the painful hip arthroplasty
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DOI：
10.1302/0301-620x.87b4
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发表时间：
2005-04-01
影响因子：
--
通讯作者：
Buell, U
中科院分区：
文献类型：
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作者：
Reinartz, P;Mumme, T;Buell, U
髋关节置换术的两个主要并发症是松动和感染。这些病理过程之间的可靠区分是困难的，因为两者都可能伴随着类似的症状。我们的目的是评估三相骨扫描（TPBS）和正电子发射断层扫描（PET）在髋关节置换术患者中检测和区分这些并发症的诊断能力。对63例患者（92个假体）进行了TPBS和PET。PET显像的放射性示踪剂为18 F-氟脱氧葡萄糖（FDG）。PET诊断的敏感性、特异性和准确性分别为0.94、0.95和0.95，而TPBS分别为0.68、0.76和0.74。我们发现，完全基于定量标准的图像解释是不合适的，因为它的低选择性。组织学检查表明，无菌性松动患者假体周围FDG摄取增加是由磨损引起的聚乙烯颗粒和随后的侵袭性肉芽肿组织生长引起的。
Two major complications of hip replacement are loosening and infection. Reliable differentiation between these pathological processes is difficult since both may be accompanied by similar symptoms. Our aim was to assess the diagnostic ability of triple-phase bone scanning (TPBS) and positron-emission tomography (PET) to detect and differentiate these complications in patients with a hip arthroplasty. Both TPBS and PET were performed in 63 patients (92 prostheses). The radiotracer for PET imaging was 18 F-fluorodeoxyglucose (FDG). Image interpretation was performed according to qualitative and quantitative criteria although the final diagnosis was based upon either surgical findings or clinical follow-up.The sensitivity, specificity and accuracy of PET was 0.94, 0.95 and 0.95 respectively, compared with 0.68, 0.76 and 0.74 for TPBS. We found that an image interpretation based exclusively upon quantitative criteria was inappropriate because of its low selectivity. The histological examination indicated that increased periprosthetic uptake of FDG in patients with aseptic loosening was caused by wear-induced polyethylene particles and the subsequent growth of aggressive granulomatous tissue.