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Die Wirbelsäule 2017; 01(04): 255-264
DOI: 10.1055/s-0043-115229
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Nuklearmedizinische Verfahren zur Diagnostik der Spondylodiszitis

Nuclear imaging in spondylodiscitis
K. H. Davis
1   Universitätsklinikum Frankfurt; Klinik für Nuklearmedizin
,
C. Happel
1   Universitätsklinikum Frankfurt; Klinik für Nuklearmedizin
,
M. Heller
2   Universitätsklinikum Frankfurt; Institut für Diagnostische und Interventionelle Radiologie
,
T. J. Vogl
2   Universitätsklinikum Frankfurt; Institut für Diagnostische und Interventionelle Radiologie
,
M. Rauschmann
3   Orthopädische Universitätsklinik Frankfurt Friedrichsheim gGmbH
,
F. Grünwald
1   Universitätsklinikum Frankfurt; Klinik für Nuklearmedizin
› Author Affiliations
Further Information

Publication History

Publication Date:
07 November 2017 (online)

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Zusammenfassung

Es existieren zahlreiche nuklearmedizinische Verfahren zur Detektion einer Spondylodiszitis (SP), welche sich in ihrer diagnostischen Wertigkeit teils deutlich unterscheiden. Während sich die Leukozyten- beziehungsweise Antikörperszintigrafie aufgrund mangelnder Sensitivität und Spezifität nicht bewährt hat, zeigt die Skelettszintigrafie gute Ergebnisse und kommt insbesondere bei Kontraindikationen zur MRT zum Einsatz. Die 18F-FDG-PET hat sich inzwischen als führende Diagnostik der SP in der nuklearmedizinischen Bildgebung durchgesetzt. Insbesondere im Vergleich zur MRT, welche bis dato den Gold-Standard der morphologisch-diagnostischen Bildgebung der SP darstellt, liefert die 18F-FDG-PET deutliche Vorteile. So zeigt sich die 18F-FDG-PET bezüglich der Differenzierung zwischen degenerativen und entzündlichen Veränderungen, der frühen Detektion der Erkrankung sowie der Evaluation des Therapieansprechens überlegen. Insgesamt liefert die Kombination aus 18F-FDG-PET und MRT eine nahezu 100 %ig korrekte Detektion infektiöser SP.

Abstract

Numerous nuclear imaging techniques exist for detection of spondylodiscitis (SP), which vary in terms of their diagnostic value. While leucocyte and antigranulocyte antibody scintigraphy show lack of sensitivity and specificity, bone scintigraphy provides satisfactory results and is used particularly when MRI is contraindicated. Today, 18F-FDG-PET is the leading method of nuclear imaging in the diagnosis of SP. MRI may be the gold standard in imaging, however 18F-FDG-PET provides many advantages. It proves to be superior regarding the differentiation between degenerative and infectious disease, early detection of SP as well as the evaluation of early therapy response. 18F-FDG-PET together with MRI show a nearly 100 % correct detection of infectious SP.

Schlüsselwörter

Spondylodiszitis - spinale Infektion - Skelettszintigrafie - 18F-FDG-PET - MRT

Keywords

spondylodiscitis - spinal infection - bone scan - 18F-FDG-PET - MRI
 

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