氧糖PET/CT的常规临床使用,以确认皮原性脊柱感染的治疗反应
Hans W Lafford1,2, Errol E Stewart3, Ingrid L Koslowsky3
1Department of Radiology, University of Calgary, Foothills Medical Centre, 1403 29 Street NW, Calgary, Alberta, T2N 2T9, Canada. hans.lafford@albertahealthservices.ca.
氧葡萄糖-正子发射断层扫描/计算机断层扫描 (FDG-PET/CT) 有效地预测火源性脊柱感染治疗的成功. 低风险的FDG-PET/CT扫描表明复发风险可以忽略不计,指导抗生素治疗决策.
科学领域:
- 核医学就是核医学.
- 传染性疾病 传染性疾病
- 整形外科手术 整形外科手术
背景情况:
- 热性脊柱感染治疗反应通常使用非特异性症状和炎症标志物进行评估.
- 磁共振成像 (MRI) 异常持续存在,限制了其在指导治疗调整中的实用性.
- 对于脊髓感染成功抗生素治疗的及时和强大的预测指标存在需求.
研究的目的:
- 评估顺序的氧葡萄糖-正子发射断层扫描/计算机断层扫描 (FDG-PET/CT) 扫描在预测pyogenic脊柱感染的治疗反应中的有效性.
- 确定FDG-PET/CT是否可以作为成功抗生素治疗的及时和可靠指标.
主要方法:
- 在4年的时间里,对107名患者进行了顺序的FDG-PET/CT扫描.
- 停用抗生素后感染复发是主要终点.
- 根据FDG-PET/CT发现,患者被分为低风险,中等风险和高风险组.
主要成果:
- 在低风险的FDG-PET/CT扫描中观察到0.99的负预测值,在最初没有感染迹象的患者中没有临床复发.
- 高风险的FDG-PET/CT发现与残留感染相关,需要进一步的抗生素治疗.
- 中期风险发现显示复发率低 (1/7),表明可能在观察下停止治疗.
结论:
- FDG-PET/CT为发热性脊柱感染提供了有效的风险分层,区分了可忽略的复发风险和需要进一步治疗的患者.
- 低风险扫描表明治疗成功,而无法解释的活性表明高风险和持续的抗生素.
- 中级风险发现表明,通过仔细监测,可以停止抗生素治疗.
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