Departments of Nuclear Medicine and Diagnostic Radiology, Galilee Medical Center, Nahariya, and the Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
Department of Nuclear Medicine, Rambam HealthCare Campus, and the Faculty of Medicine, Technion - the Israeli Institute of Technology, Haifa, Israel.
Semin Nucl Med. 2023 Jan;53(1):70-77. doi: 10.1053/j.semnuclmed.2022.08.006. Epub 2022 Sep 11.
Vascular graft infection is a rare, life threatening complication of vascular repair with synthetic or native material. The pathogenesis, causative microorganisms and clinical manifestations vary according to graft's location and time duration since surgery. The diagnosis of graft infection is challenging since there is no single "gold standard" test and diagnosis is based on clinical and radiological criteria. Early and accurate diagnosis are essential for patient management and prevention of further complications. The first-choice imaging modality is computed tomography angiography (CTA) that can demonstrate typical signs of graft infection but has limited sensitivity and specificity, especially in early and low-grade infections. Nuclear medicine imaging methods, including labeled white blood cell scintigraphy and FDG PET/CT demonstrate improved diagnostic accuracy and play a pivotal role in the diagnosis of vascular graft infection. The different radiologic and the nuclear medicine imaging techniques, their advantages and limitations, and the recent guidelines detailing their use are reviewed.
血管移植物感染是一种罕见的、危及生命的血管修复并发症，涉及合成或天然材料。发病机制、病原体微生物和临床表现因移植物位置和手术后时间长短而异。由于没有单一的“金标准”检测方法，且诊断基于临床和影像学标准，因此移植物感染的诊断具有挑战性。早期和准确的诊断对于患者管理和预防进一步并发症至关重要。首选的影像学检查方法是计算机断层血管造影（CTA），它可以显示典型的移植物感染征象，但敏感性和特异性有限，尤其是在早期和低度感染中。核医学成像方法，包括标记白细胞闪烁扫描和 FDG PET/CT，可提高诊断准确性，并在血管移植物感染的诊断中发挥关键作用。本文回顾了不同的放射学和核医学成像技术、它们的优缺点以及详细说明其用途的最新指南。
