Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Nuclear Medicine Institute of Fudan University, Shanghai, China.
Int Wound J. 2020 Aug;17(4):1019-1027. doi: 10.1111/iwj.13368. Epub 2020 Apr 16.
Deep sternal wound infection (DSWI) is a severe complication in patients after open heart surgery (OHS). But there is a lack of appropriate imaging tool to detect the infection sites, which may lead to incomplete debridement. The present study aims to investigate the value of F-fluorodeoxyglucose positron emission tomography/computed tomography ( F-FDG PET/CT) in comparison with CT scan in diagnosing and localising DSWI. A total of 102 patients with DSWI after OHS were retrospectively collected from January 2012 to December 2017 in our hospital. All the patients had surgical debridements for DSWI with pretreatment imaging of either F-FDG PET/CT or CT scan. The sensitivity, specificity, and accuracy of localising infection sites were compared between PET/CT and CT groups, with surgical, microbiological, and histopathological findings as the gold standard. The length of hospital stays and the rate of recurrence were also compared. Ten patients in the PET/CT group had a follow-up PET/CT scan after debridement, and the correlations between the changes of PET/CT findings and surgical outcomes were analysed. F-FDG PET/CT is more accurate than CT in diagnosing and localising DSWI after OHS, which leads to a more successful surgical debridement with a lower rate of recurrence and a shorter length of hospital stay. In addition, follow-up PET/CT after debridement could evaluate the treatment effect.
深部胸骨伤口感染（DSWI）是心脏直视手术后（OHS）患者的严重并发症。但缺乏适当的影像学工具来检测感染部位，这可能导致清创不彻底。本研究旨在探讨 F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（ F-FDG PET/CT）与 CT 扫描在诊断和定位 DSWI 中的价值。回顾性收集了 2012 年 1 月至 2017 年 12 月我院 102 例 OHS 后 DSWI 患者的资料。所有患者均因 DSWI 行外科清创术，术前行 F-FDG PET/CT 或 CT 扫描。以手术、微生物和组织病理学结果为金标准，比较 PET/CT 组和 CT 组定位感染部位的灵敏度、特异性和准确性，比较两组的住院时间和复发率。10 例 PET/CT 组患者在清创术后行随访 PET/CT 扫描，分析 PET/CT 检查结果的变化与手术结果的相关性。 F-FDG PET/CT 对 OHS 后 DSWI 的诊断和定位准确性优于 CT，可提高外科清创术的成功率，降低复发率，缩短住院时间。此外，清创术后的随访 PET/CT 可评估治疗效果。
