IMAGING INFECTION 

The Quarterly Journal of Nuclear Medicine 1999 March;43(1):21-8

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Imaging techniques for evaluation of postoperative orthopedic infections

Seabold J. E., Nepola J. V.

From the Departments of Radiology Division of Nuclear Medicine and Orthopedic Surgery University of Iowa College of Medicine Iowa City, Iowa, USA

Labeled leu­ko­cyte scin­tig­raphy is the pre­ferred ­imaging tech­nique for the eval­u­a­tion of sus­pected post­op­er­a­tive ortho­pedic infec­tions. ­Labeled leu­ko­cyte local­iza­tion ­returns to a ­normal pat­tern ­faster ­than MRI ­after ­bone ­trauma, sur­gical pro­ce­dures, and treat­ment of osteo­my­e­litis. 99mTc ­HMPAO ­labeled leu­ko­cyte scin­tig­raphy is ­useful, par­tic­u­larly in chil­dren, ­because ­less periph­eral ­blood ­volume is ­required for ­labeling. How­ever, ­delayed 16-20 ­hour ­imaging is usu­ally ­needed to ­detect low-­grade osteo­my­e­litis, and 111In WBC usu­ally pro­vides ­better ­images in ­adults. Com­bined 111In WBC/99mTc ­sulfur col­loid ­marrow ­images ­improve the spec­i­ficity for detec­tion of osteo­my­e­litis in ­regions con­taining ­active ­bone ­marrow. Simul­ta­neous 111In leu­ko­cyte/99mTc ­bone ­SPECT ­imaging is usu­ally nec­es­sary in ­regions ­such as the ­skull, ­spine, and ­hips, ­where ­there is over­lap­ping ­bone, and ­soft tis­sues.