Schmitz A, Risse H J, Kälicke T, Grünwald F, Schmitt O
Klinik und Poliklinik für Orthopädie, Rhein.-Fried.-Wilh.-Universität, Bonn.
Z Orthop Ihre Grenzgeb. 2000 Sep-Oct;138(5):407-12. doi: 10.1055/s-2000-10169.
The diagnosis and the assessment of osteomyelitis and spondylodiscitis can be difficult. The aim of this study was to evaluate the usefulness of FGD-PET in the detection of inflammatory processes.
23 orthopedic patients suspected of having peripheral osteomyelitis (n = 13) or spondylodiscitis (n = 10) were examined consecutively with FDG-PET. The FDG-PET scans were evaluated by the nuclear physicians in ignorance of the clinical diagnosis by visual interpretation, which was graded on a five-point scale (0 = no infection-4 = definitely infection).
Of 23 patients, 15 had osteomyelitis (n = 8) or spondylodiscitis (n = 7). In these 15 cases, the FDG-PET was true-positive. The sensitivity was 100%. In the 8 cases without infection, the FDG-PET was in 5 cases true-negative and in 3 cases false-positive. Even with inlying metal implants, soft-tissue abscesses could be differentiated from the bony process.
The FDG-PET is a very sensitive procedure for the diagnosis of osteomyelitis and spondylodiscitis and for screening of inflammation foci. A further advantage is the high spatial solution. The quantification of the inflammatory activity allowed a monitoring of the therapy.
骨髓炎和脊椎椎间盘炎的诊断与评估可能存在困难。本研究的目的是评估氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）在检测炎症过程中的效用。
对23例疑似患有外周骨髓炎（n = 13）或脊椎椎间盘炎（n = 10）的骨科患者连续进行FDG-PET检查。核医学医师在不知临床诊断的情况下通过视觉解读对FDG-PET扫描进行评估，评估采用五点量表分级（0 = 无感染 - 4 = 肯定有感染）。
23例患者中，15例患有骨髓炎（n = 8）或脊椎椎间盘炎（n = 7）。在这15例病例中，FDG-PET结果为真阳性。敏感性为100%。在8例无感染的病例中，FDG-PET在5例中结果为真阴性，在3例中为假阳性。即使存在内置金属植入物，软组织脓肿也能与骨质病变区分开来。
FDG-PET是诊断骨髓炎和脊椎椎间盘炎以及筛查炎症病灶的一种非常敏感的检查方法。另一个优点是具有高空间分辨率。炎症活性的量化有助于监测治疗情况。
