Department of Radiology and Nuclear Medicine, Erasmus Medical Center, ND-547, Dr. Molewaterplein 40, 015GD, Rotterdam, The Netherlands.
Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
J Nucl Cardiol. 2023 Jun;30(3):1210-1218. doi: 10.1007/s12350-022-03126-x. Epub 2022 Nov 8.
The clinical diagnosis of deep sternal wound infection (DSWI) is supported by imaging findings including 18F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG-PET/CT). To avoid misinterpretation due to normal post-surgery inflammation we assessed normal imaging findings in non-infected patients after sternotomy.
This is a prospective cohort study including non-infectious patients with sternotomy. All patients underwent F-FDG-PET/CT at either 5 weeks (group 1), 12 weeks (group 2) or 52 weeks (group 3) post-surgery. F-FDG uptake was scored visually in five categories and assessed quantitatively.
A total of 44 patients were included. Sternal mean SUVmax was 7.34 (± 1.86), 5.22 (± 2.55) and 3.20 (± 1.80) in group 1, 2 and 3, respectively (p < 0.01). Sternal mean SUVmean was 3.84 (± 1.00), 2.69 (± 1.32) and 1.71 (± 0.98) in group 1, 2 and 3 (p < 0.01). All patients in group 1 had elevated uptake whereas group 2 and 3 showed 2/15 (13%) and 11/20 (55%) patients respectively with no elevated uptake. Group 3 still showed an elevated uptake pattern in in 9/20 (45%) and in 3/9 (33%) with a high-grade diffuse uptake pattern.
This study shows significant lower sternal F-FDG at 55 weeks compared to 5 weeks post-sternotomy however elevated uptake patterns may persist.
18F-氟代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）的影像学表现支持深部胸骨伤口感染（DSWI）的临床诊断。为了避免由于手术后正常炎症而导致的误诊，我们评估了胸骨切开术后非感染患者的正常影像学表现。
这是一项包括非感染性胸骨切开术患者的前瞻性队列研究。所有患者均在手术后 5 周（第 1 组）、12 周（第 2 组）或 52 周（第 3 组）进行 F-FDG-PET/CT 检查。通过 5 个类别进行视觉评分和定量评估 F-FDG 摄取。
共纳入 44 例患者。第 1、2 和 3 组胸骨 SUVmax 的平均值分别为 7.34（±1.86）、5.22（±2.55）和 3.20（±1.80）（p<0.01）。第 1、2 和 3 组胸骨 SUVmean 的平均值分别为 3.84（±1.00）、2.69（±1.32）和 1.71（±0.98）（p<0.01）。第 1 组所有患者摄取均升高，而第 2 和第 3 组分别有 2/15（13%）和 11/20（55%）的患者摄取不升高。第 3 组在 20 例患者中有 9 例（45%）和在 9 例中有 3 例（33%）仍表现为摄取升高模式，表现为高分级弥漫性摄取模式。
本研究表明，与胸骨切开术后 5 周相比，55 周时胸骨 F-FDG 摄取显著降低，但摄取升高模式可能持续存在。
