Zusammenfassung
In der nuklearmedizinischen Diagnostik der akuten Osteomyelitis stellt die Drei-Phasen-Knochenszintigrafie
aufgrund ihrer hohen Sensitivität nach wie vor die Methode der Wahl dar. Bei nicht
eindeutigem Befund sollte sie durch mit 99mTc in vitro oder in vivo markierte Leukozyten ergänzt werden. Bei der chronischen
Osteomyelitis kann aufgrund des mittlerweile vorliegenden Datenmaterials die FDG-PET
als das zuverlässigste bildgebende Verfahren angesehen werden. Ist sie nicht verfügbar,
sollten bei Lokalisation der Osteomyelitis außerhalb der Wirbelsäule die Drei-Phasen-Knochenszintigrafie,
in vitro oder in vivo markierte Leukozyten, die Galliumszintigrafie oder auch die
Nanokolloidszintigrafie zum Einsatz kommen. Die FDG-PET hat auch in der Diagnostik
der Spondylodiszitis ihre Überlegenheit gegenüber allen anderen bildgebenden Verfahren
bewiesen. Sie wird gefolgt von der Galliumszintigrafie.
Abstract
In diagnosing acute osteomyelitis three-phase bone scintigraphy still represents the
method of choice within the nuclear medicine armamentarium due to its high sensitivity.
If the finding is indeterminate, it should be supplemented by 99mTc-leukocyte scintigraphy either with in vitro or in vivo labelled leukocytes. Based
on data available so far, FDG-PET can meanwhile be considered as the most reliable
imaging procedure in chronic osteomyelitis. If it is not available, three-phase bone
scintigraphy, in vitro or in vivo labelled leukocytes, gallium or nanocolloid scintigraphy
should be applied in non-spinal osteomyelitis. FDG-PET has proven its superiority
over all the other imaging methods in spinal infection as well. It is followed by
gallium scintigraphy.
Schlüsselwörter
Osteomyelitis - Spondylodiszitis - Szintigrafie - FDG - PET - markierte Leukozyten
- Gallium
Key words
osteomyelitis - spinal infection - scintigraphy - FDG - PET - labelled leukocytes
- gallium
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