Martin A, Moisan A, Chalès G, Le Cloirec J, Herry J Y, Pawlotsky Y
Clinique Thérapeutique, Service de Médecine Interne et de Rhumatologie, Hôpital Sud, Rennes.
Rev Chir Orthop Reparatrice Appar Mot. 1988;74(7):604-8.
Fifty-three patients with suspected infection of prosthetic joints had Indium-111 granulocyte scintigraphy. Twenty-nine of them had associated technetium-99m phosphate scans. Labelled granulocyte sensitivity was 82% and specificity 100% for the group of 47 patients with suspected late infection. Technetium phosphate sensitivity was 92% and specificity 25%. The main quality of labelled granulocyte scintigraphy is its high specificity: there were no false positives in our series. Its main limitation seems to be that sensitivity is sometimes only moderate: we had 4 false negatives. The probable explanation is the histological characteristics of bone infection: vascular thromboses occur frequently and at an early stage, the inflammatory infiltrate is not very abundant and often has a low granulocyte content. The method is therefore reliable and can be used in situations where diagnosis of periprosthetic infection is difficult with conventional techniques.
53例疑似人工关节感染的患者接受了铟-111粒细胞闪烁扫描。其中29例还进行了锝-99m磷酸盐扫描。对于47例疑似晚期感染的患者，标记粒细胞扫描的敏感性为82%，特异性为100%。磷酸盐扫描的敏感性为92%，特异性为25%。标记粒细胞闪烁扫描的主要优点是其高特异性：在我们的系列研究中没有假阳性。其主要局限性似乎是敏感性有时仅为中等：我们有4例假阴性。可能的解释是骨感染的组织学特征：血管血栓形成频繁且发生较早，炎症浸润不太丰富且粒细胞含量通常较低。因此，该方法可靠，可用于传统技术难以诊断假体周围感染的情况。
