Demirkol M O, Adalet I, Unal S N, Tözün R, Cantez S
Department of Nuclear Medicine, Istanbul University, Istanbul Medical Faculty, Capa-Istanbul, Turkey.
Nucl Med Commun. 1997 Jun;18(6):543-8. doi: 10.1097/00006231-199706000-00008.
We investigated the usefulness of 99Tc(m)-polyclonal human IgG (99Tc[m]-HIG) scintigraphy in the diagnosis of infected hip and knee prostheses. Twenty-nine scintigraphic studies were performed in 27 patients (17 females, 10 males) with a suspected prosthetic infection. As some patients had bilateral prostheses, a total of 35 prostheses were evaluated. There were 25 hip replacements and 10 knee prostheses. The images were analysed both visually and quantitatively. The scintigraphic results were compared with the culture results of surgical specimens and also with clinical follow-up after 3 months. Increased uptake was observed in 22 prostheses, of which 12 were true-positive and 10 were false-positive results. Staphylococci were the agents most commonly isolated. In all false-positive patients, aseptic inflammation was diagnosed. Based on quantitative analysis, no statistically significant difference was found between the true-positive and false-positive cases. For the prostheses as a whole, the sensitivity, specificity, positive predictive value and negative predictive value were 100%, 41%, 54% and 100% respectively. For the hip prostheses alone, these values were 100%, 53%, 57% and 100% respectively. Taking its high sensitivity and predictive value into consideration, 99Tc(m)-HIG scintigraphy can be used as a screening test to help eliminate prosthetic infection.
我们研究了99锝（m）-多克隆人免疫球蛋白（99Tc[m]-HIG）闪烁扫描术在诊断感染性髋和膝关节假体中的作用。对27例（17例女性，10例男性）疑似假体感染患者进行了29次闪烁扫描研究。由于部分患者为双侧假体，共评估了35个假体。其中有25个髋关节置换物和10个膝关节假体。对图像进行了视觉和定量分析。将闪烁扫描结果与手术标本的培养结果以及3个月后的临床随访结果进行了比较。在22个假体中观察到摄取增加，其中12个为真阳性，10个为假阳性结果。葡萄球菌是最常分离出的病原体。在所有假阳性患者中，诊断为无菌性炎症。基于定量分析，真阳性和假阳性病例之间未发现统计学上的显著差异。对于整个假体，敏感性、特异性、阳性预测值和阴性预测值分别为100%、41%、54%和100%。仅对于髋关节假体，这些值分别为100%、53%、57%和100%。考虑到其高敏感性和预测价值，99Tc(m)-HIG闪烁扫描术可作为一种筛查试验，以帮助排除假体感染。
