Department of Orthopedic Surgery, Faculty of Medicine, Oita University, Yufu, Japan.
Clin Orthop Surg. 2021 Sep;13(3):320-328. doi: 10.4055/cios20228. Epub 2021 Aug 17.
Plain computed tomography (CT) and magnetic resonance imaging (MRI) are useful for diagnosing adverse local tissue reactions after metal-on-metal total hip arthroplasty (THA), but metal artifacts can hamper radiological assessments near the implants. We sought to clarify the usefulness of 18F-fluorodeoxyglucose positron-emission tomography (18F-FDG-PET) CT and MRI in the periprosthetic region, which is difficult to assess after THA due to metal artifacts.
We performed preoperative 18F-FDG-PET/CT and 18F-FDG-PET/MRI, as well as plain CT and MRI, in 11 metal-on-metal THA patients who underwent revision surgery.
Most patients showed high FDG uptake in the metal artifact areas and pseudotumors in the 18-F-FDG-PET/CT and 18-F-FDG-PET/MRI scans. Intraoperative intra-articular macroscopic and histopathological intra-articular granulation tissue findings were suggestive of adverse local tissue reaction.
The enhanced uptake in the metal artifact areas seemed to reflect adverse local tissue reaction. Therefore, 18F-FDG-PET/CT and 18-F-FDG-PET/MRI can be useful for the auxiliary diagnosis of adverse local tissue reactions after metal-on-metal THA.
普通计算机断层扫描（CT）和磁共振成像（MRI）可用于诊断金属对金属全髋关节置换术后不良局部组织反应，但金属伪影会妨碍植入物附近的影像学评估。我们旨在阐明正电子发射断层扫描（18F-FDG-PET）CT 和 MRI 在假体周围区域的有用性，由于金属伪影，THA 后很难对该区域进行评估。
我们对 11 例接受翻修手术的金属对金属 THA 患者进行了术前 18F-FDG-PET/CT 和 18F-FDG-PET/MRI 以及普通 CT 和 MRI。
大多数患者在 18F-FDG-PET/CT 和 18F-FDG-PET/MRI 扫描中，金属伪影区域和假肿瘤显示出高 FDG 摄取。术中关节内肉眼观察和关节内组织学肉芽组织发现提示存在不良局部组织反应。
金属伪影区域的摄取增强似乎反映了不良局部组织反应。因此，18F-FDG-PET/CT 和 18F-FDG-PET/MRI 可用于辅助诊断金属对金属 THA 后的不良局部组织反应。
