使用三相 99mTc-羟甲基二膦酸盐 SPECT/CT 的标准摄取值诊断人工髋关节感染。

Diagnosis of prosthetic joint infection at the hip using the standard uptake value of three-phase 99mTc-hydroxymethylene diphosphonate SPECT/CT.

机构信息

Department of Diagnostic Radiology, Sapporo Medical University, South 1 West 17, Chuo-Ku, Sapporo, 060-8556, Japan.

Department of Musculoskeletal Biomechanics and Surgical Development, Sapporo Medical University, Sapporo, Japan.

出版信息

Ann Nucl Med. 2022 Jul;36(7):634-642. doi: 10.1007/s12149-022-01745-5. Epub 2022 Apr 28.

DOI:10.1007/s12149-022-01745-5

PMID:35482179

Abstract

PURPOSE

To retrospectively investigate whether the standard uptake value (SUV) of 99mTc-bone single-photon emission computed tomography (SPECT)/CT could be useful for predicting prosthetic joint infection (PJI) at the hip.

PATIENTS AND METHODS

We analyzed the cases of 37 patients with a suspected PJI at the hip who underwent 99mTc-bone SPECT/CT and surgical intervention with pathological and bacterial examinations. We divided the cases into those with and those without a causative bacterium detected in a surgical specimen, i.e., the positive bacterial culture (PBC) group (n = 17) and negative bacterial culture (NBC) group (n = 20). Cases with neutrophilic infiltration of surgical specimen comprised the positive neutrophilic infiltration (PINF) group (n = 18) and those without INF comprised the non-neutrophilic infiltration (NINF) group (n = 19). Quantitative analyses were performed using maximum SUVs and peak SUVs of blood-pool (BP) phase images (SUVmaxBP and SUVpeakBP) and late (LT)-phase images (SUVmaxLT and SUVpeakLT).

RESULTS

Regarding the bacterial cultures, there were significant differences between the PBC and NBC groups in SUVmaxBP (5.26 ± 1.49 vs. 4.21 ± 1.15, respectively; p = 0.019), SUVpeakBP (4.89 ± 1.32 vs. 3.87 ± 1.06, p = 0.012), SUVmaxLT (16.10 ± 6.36 vs. 11.67 ± 4.95, p = 0.026), and SUVpeakLT (14.58 ± 5.83 vs. 10.49 ± 4.31 p = 0.036). Regarding neutrophilic infiltration, there were significant differences between the PINF and NINF groups in SUVmaxBP (5.18 ± 1.48 vs. 4.24 ± 1.19, p = 0.047) and SUVpeakBP (4.78 ± 1.32 vs. 3.92 ± 1.10, p = 0.043).

CONCLUSION

An SUV analysis of 99mTc-bone SPECT/CT is a useful method to differentiate a PJI at the hip from non-infection.

摘要

目的

回顾性分析 99mTc 骨单光子发射计算机断层扫描（SPECT）/CT 的标准摄取值（SUV）是否可用于预测髋关节假体关节感染（PJI）。

方法

我们分析了 37 例疑似髋关节 PJI 患者的病例，这些患者均接受了 99mTc 骨 SPECT/CT 检查和手术干预，并进行了病理和细菌检查。我们将病例分为手术标本中检测到有和无病原体的两组，即阳性细菌培养（PBC）组（n=17）和阴性细菌培养（NBC）组（n=20）。手术标本中性粒细胞浸润的病例为阳性中性粒细胞浸润（PINF）组（n=18），无中性粒细胞浸润的病例为非中性粒细胞浸润（NINF）组（n=19）。使用血池（BP）相图像（SUVmaxBP 和 SUVpeakBP）和延迟（LT）相图像（SUVmaxLT 和 SUVpeakLT）的最大 SUV 和峰值 SUV 进行定量分析。

结果

在细菌培养方面，PBC 组和 NBC 组的 SUVmaxBP（5.26±1.49 比 4.21±1.15，p=0.019）、SUVpeakBP（4.89±1.32 比 3.87±1.06，p=0.012）、SUVmaxLT（16.10±6.36 比 11.67±4.95，p=0.026）和 SUVpeakLT（14.58±5.83 比 10.49±4.31，p=0.036）存在显著差异。在中性粒细胞浸润方面，PINF 组和 NINF 组的 SUVmaxBP（5.18±1.48 比 4.24±1.19，p=0.047）和 SUVpeakBP（4.78±1.32 比 3.92±1.10，p=0.043）存在显著差异。