Guhlmann A, Brecht-Krauss D, Suger G, Glatting G, Kotzerke J, Kinzl L, Reske S N
Department of Radiology III, University of Ulm, Germany.
Radiology. 1998 Mar;206(3):749-54. doi: 10.1148/radiology.206.3.9494496.
To evaluate use of positron emission tomography (PET) with 2-(fluorine-18) fluoro-2-deoxy-D-glucose (FDG) in detection of chronic osteomyelitis.
Thirty-one patients suspected to have chronic osteomyelitis in the peripheral (n = 21) or central (n = 10) skeleton were evaluated prospectively with FDG PET. Analysis of the receiver operating characteristic curve was performed. The final diagnosis was made by means of bacteriologic culture of surgical specimens and histopathologic analysis.
FDG PET allowed identification of 17 of 18 patients with osteomyelitis and 12 of 13 without osteomyelitis. There was one false-positive and one equivocal result. The area under the ROC curve was 0.96 for all patients, 1.00 for patients suspected to have osteomyelitis in the peripheral skeleton, and 0.88 for patients suspected to have osteomyelitis in the central skeleton. The overall accuracy of FDG PET was 97% with a high degree of interobserver concordance (kappa = 0.93). The overall sensitivity and specificity were 100% and 92%, respectively.
FDG PET enables noninvasive detection and demonstration of the extent of chronic osteomyelitis with a high degree of accuracy. Especially in the central skeleton within active bone marrow, FDG PET is highly accurate and shows great promise in diagnosis of chronic osteomyelitis.
评估2-（氟-18）氟-2-脱氧-D-葡萄糖（FDG）正电子发射断层扫描（PET）在慢性骨髓炎检测中的应用。
对31例疑似外周骨骼（n = 21）或中央骨骼（n = 10）慢性骨髓炎的患者进行FDG PET前瞻性评估。绘制并分析受试者操作特征曲线。最终诊断通过手术标本的细菌培养和组织病理学分析得出。
FDG PET能够识别18例骨髓炎患者中的17例以及13例非骨髓炎患者中的12例。有1例假阳性和1例结果不明确。所有患者的ROC曲线下面积为0.96，外周骨骼疑似骨髓炎患者为1.00，中央骨骼疑似骨髓炎患者为0.88。FDG PET的总体准确率为97%，观察者间一致性较高（kappa = 0.93）。总体敏感性和特异性分别为100%和92%。
FDG PET能够以高度准确性对慢性骨髓炎进行无创检测并显示其范围。特别是在活跃骨髓内的中央骨骼中，FDG PET高度准确，在慢性骨髓炎诊断中显示出巨大前景。
