Zhuang Hongming, Sam Joseph W, Chacko Thomas K, Duarte Paulo S, Hickeson Marc, Feng Qi, Nakhoda Kozaim Z, Guan Liang, Reich Phillip, Altimari Shirley M, Alavi Abass
Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, 110 Donner Bldg, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Eur J Nucl Med Mol Imaging. 2003 Aug;30(8):1096-103. doi: 10.1007/s00259-003-1198-x. Epub 2003 May 22.
It is known that following a traumatic fracture or surgical intervention, bone scintigraphy reveals positive results for an extended period of time, posing a challenge when evaluating patients for possible malignancy or superimposed osteomyelitis. Previous reports indicate that acute fractures can also result in increased fluorine-18 fluorodeoxyglucose (FDG) accumulation and therefore cause difficulties when patients are evaluated for other indications by FDG-PET. The purpose of this study was to assess the pattern and time course of abnormal FDG uptake following traumatic or surgical fracture. A total of 1,517 consecutive patients who underwent whole-body FDG-PET imaging were retrospectively studied. A history of fractures or orthopedic intervention was obtained from an interview prior to scanning. The FDG-PET results were compared with the results of other imaging studies, including bone scans, radiographs, CT, and MRI, as well as surgical pathology reports. Thirty-seven patients with a known date of traumatic or surgical fracture were identified. Among these, 14 had fractures or surgery within 3 months prior to FDG-PET, while 23 had fractures or surgical intervention greater than 3 months prior to FDG-PET. FDG-PET showed no abnormally increased uptake at the known fracture or surgical sites in 30 of these patients. Notably, in the 23 patients with fractures more than 3 months old, all but one showed no abnormally increased uptake. Furthermore, the positive FDG uptake in this exception was a result of complicating osteomyelitis. In the 14 patients with a history of fracture less than 3 months old, only six had abnormally increased FDG uptake. Following traumatic or surgical fractures, FDG uptake is expected to be normal within 3 months unless the process is complicated by infection or malignancy.
众所周知，在创伤性骨折或手术干预后，骨闪烁显像在较长一段时间内都会显示阳性结果，这在评估患者是否可能患有恶性肿瘤或叠加性骨髓炎时构成了挑战。先前的报告表明，急性骨折也会导致氟-18氟脱氧葡萄糖（FDG）摄取增加，因此在通过FDG-PET评估患者的其他指征时会造成困难。本研究的目的是评估创伤性或手术性骨折后FDG摄取异常的模式和时间进程。对总共1517例连续接受全身FDG-PET成像的患者进行了回顾性研究。在扫描前通过访谈获取骨折或骨科干预史。将FDG-PET结果与其他影像学检查结果进行比较，包括骨扫描、X线片、CT和MRI，以及手术病理报告。确定了37例已知创伤性或手术性骨折日期的患者。其中，14例在FDG-PET检查前3个月内发生骨折或进行了手术，而23例在FDG-PET检查前3个月以上发生骨折或进行了手术干预。在这些患者中，30例的FDG-PET显示已知骨折或手术部位没有异常增加的摄取。值得注意的是，在23例骨折超过3个月的患者中，除1例之外均未显示异常增加的摄取。此外，这一例外情况中FDG摄取阳性是由并发骨髓炎导致的。在14例骨折史少于3个月的患者中，只有6例FDG摄取异常增加。创伤性或手术性骨折后，除非过程并发感染或恶性肿瘤，预计3个月内FDG摄取正常。
