Department of Pediatric Surgery, University Children's Hospital, 72076 Tübingen, Germany.
J Pediatr Surg. 2011 Aug;46(8):1550-6. doi: 10.1016/j.jpedsurg.2010.11.037.
Magnetic resonance imaging (MRI) and/or scintigraphy are commonly used for follow-up in children after treatment of acute osteomyelitis. Regularly, post-treatment imaging reveals pathological findings even if serum inflammatory parameters and clinical presentation are normal. We analyzed combined positron emission tomography and multislice computed tomography (PET/CT) for this condition.
Six children received PET/CT after treatment of acute osteomyelitis. Post-treatment MRI had revealed suspicious residual and/or additional findings. All patients had physiological serum infection parameters and no clinical symptoms.
Median patient age was 59.5 months (range, 48-156). No increased 18-Fluor-2-deoxy-D-glucose uptake was observed in 3 patients. In 3 patients, there was minimal activity at the site of infection, which, however, did not reach the presumed range of osteomyelitis. All children were taken off antibiotic medication. No clinical symptoms reoccurred in any of them, and repeatedly controlled serum infection parameters were all normal. Median follow-up was 33 months (range, 4-65).
The PET/CT was superior to MRI in distinguishing between infection and reparative activity within the musculoskeletal system in selected children after acute osteomyelitis. The termination of antibiotic treatment for children after acute osteomyelitis seems justified when laboratory parameters as well as clinical presentation are normal, and PET/CT scan is unsuspicious.
磁共振成像（MRI）和/或闪烁扫描通常用于急性骨髓炎治疗后的儿童随访。即使血清炎症参数和临床表现正常，治疗后的影像学检查通常仍会显示病理性发现。我们对此种情况进行了正电子发射断层扫描和多层计算机断层扫描（PET/CT）联合分析。
6 名儿童在急性骨髓炎治疗后接受了 PET/CT 检查。治疗后 MRI 显示可疑的残留和/或其他发现。所有患者的血清感染参数均正常且无临床症状。
患者的中位年龄为 59.5 个月（范围，48-156 个月）。3 名患者未观察到 18F-氟代脱氧葡萄糖摄取增加。在 3 名患者中，感染部位仅有轻微的活性，但未达到骨髓炎的假定范围。所有患儿均停用抗生素。他们均未出现任何临床症状，且反复检查的血清感染参数均正常。中位随访时间为 33 个月（范围，4-65 个月）。
在急性骨髓炎治疗后，对选择的儿童，与 MRI 相比，PET/CT 可更好地鉴别骨骼肌肉系统中的感染与修复活动。当实验室参数和临床表现正常且 PET/CT 扫描无异常时，对急性骨髓炎儿童停止抗生素治疗似乎是合理的。
