18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描在诊断人工血管移植物感染中的应用

18F-Fluorodeoxyglucose positron emission tomography/CT scanning in diagnosing vascular prosthetic graft infection.

作者信息

Saleem Ben R, Pol Robert A, Slart Riemer H J A, Reijnen Michel M P J, Zeebregts Clark J

机构信息

Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, 9700 RB Groningen, The Netherlands.

Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, 9700 RB Groningen, The Netherlands.

出版信息

Biomed Res Int. 2014;2014:471971. doi: 10.1155/2014/471971. Epub 2014 Aug 19.

Abstract

Vascular prosthetic graft infection (VPGI) is a severe complication after vascular surgery. CT-scan is considered the diagnostic tool of choice in advanced VPGI. The incidence of a false-negative result using CT is relatively high, especially in the presence of low-grade infections. (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) scanning has been suggested as an alternative for the diagnosis and assessment of infectious processes. Hybrid (18)F-FDG PET/CT has established the role of (18)F-FDG PET for the assessment of suspected VPGI, providing accurate anatomic localization of the site of infection. However, there are no clear guidelines for the interpretation of the uptake patterns of (18)F-FDG as clinical tool for VPGI. Based on the available literature it is suggested that a linear, diffuse, and homogeneous uptake should not be regarded as an infection whereas focal or heterogeneous uptake with a projection over the vessel on CT is highly suggestive of infection. Nevertheless, (18)F-FDG PET and (18)F-FDG PET/CT can play an important role in the detection of VPGI and monitoring response to treatment. However an accurate uptake and pattern recognition is warranted and cut-off uptake values and patterns need to be standardized before considering the technique to be the new standard.

摘要

血管人工移植物感染(VPGI)是血管手术后的一种严重并发症。CT扫描被认为是晚期VPGI的首选诊断工具。使用CT出现假阴性结果的发生率相对较高,尤其是在存在低度感染的情况下。氟脱氧葡萄糖正电子发射断层扫描((18)F-FDG PET)已被建议作为诊断和评估感染过程的一种替代方法。(18)F-FDG PET/CT融合成像已确立了(18)F-FDG PET在评估疑似VPGI中的作用,可提供感染部位准确的解剖定位。然而,对于将(18)F-FDG的摄取模式作为VPGI的临床工具进行解读,尚无明确的指南。根据现有文献,建议线性、弥漫性和均匀性摄取不应被视为感染,而CT上在血管上有投影的局灶性或不均匀性摄取则高度提示感染。尽管如此,(18)F-FDG PET和(18)F-FDG PET/CT在VPGI的检测和监测治疗反应方面可发挥重要作用。然而,在将该技术视为新标准之前,需要进行准确的摄取和模式识别,并且摄取截断值和模式需要标准化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ea5/4156987/0b807c62235a/BMRI2014-471971.001.jpg

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