Nuclear Medicine Section, Department of Radiology, The University Hospital, UMDNJ, Newark, NJ 07103, USA.
Ann Nucl Med. 2009 Oct;23(8):701-8. doi: 10.1007/s12149-009-0296-7. Epub 2009 Aug 29.
Orthopedic surgical procedures often create some special postoperative complications, which may demonstrate abnormally increased or focal uptake for an extended period of time on FDG PET-CT images. The distinction of normal from pathologic, benign from malignant uptake is very important to minimize the number of false positive results. To date, very little data have been published regarding surgical-related benign musculoskeletal uptake on PET-CT imaging. In this paper, we present to the readers some case examples of FDG PET-CT imaging for postoperative fracture, infection or osteomyelitis, metallic implants, aggressive bone edge, heterotopic ossification, granuloma and neuroma. We also discuss potential pitfalls to recognize these orthopedic surgery-related complications and identify benign nature of increased FDG uptake. In all cases, the patient's medical and surgical history would be of paramount importance to the radiologists/nuclear medicine physicians who interprets the scan. It is also crucial to carefully correlate FDG uptake with the anatomy on the co-registered CT images in all transaxial, coronal and sagittal views in order to identify the location and pattern of uptake.
骨科手术常导致一些特殊的术后并发症，在 FDG PET-CT 图像上可表现为异常增高或局灶性摄取，持续较长时间。区分正常与病理性、良性与恶性摄取对于减少假阳性结果非常重要。迄今为止，关于术后骨折、感染或骨髓炎、金属植入物、侵袭性骨缘、异位骨化、肉芽肿和神经瘤等良性肌骨摄取的 PET-CT 成像相关数据非常少。在本文中，我们向读者展示了一些 FDG PET-CT 成像的病例，包括术后骨折、感染或骨髓炎、金属植入物、侵袭性骨缘、异位骨化、肉芽肿和神经瘤。我们还讨论了识别这些与骨科手术相关的并发症以及确定 FDG 摄取增加为良性性质的潜在陷阱。在所有情况下，患者的病史和手术史对于解读扫描的放射科医生/核医学医师非常重要。仔细将 FDG 摄取与同机 CT 图像的解剖结构相关联，在所有横断位、冠状位和矢状位视图中，以识别摄取的位置和模式也非常重要。
