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Z Orthop Ihre Grenzgeb 2003; 141(5): 540-546
DOI: 10.1055/s-2003-42848
Hüftendoprothetik
© Georg Thieme Verlag Stuttgart · New York

Die [F-18]-Fluorodeoxyglucose (FDG) Positronenemissionstomographie (PET) als Differenzialdiagnostikum der Hüftendoprothesenlockerung

[F-18]-Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) as a Diagnostic for Hip Endoprosthesis LooseningT.  Mumme1 , P.  Reinartz2 , U.  Cremerius2 , B.  Hermanns3 , R.  Müller-Rath1 , M.  Neuss1 , U.  Büll2 , D.  C.  Wirtz1
  • 1Orthopädische Klinik, Universitätsklinikum Aachen
  • 2Klinik für Nuklearmedizin,Universitätsklinikum Aachen
  • 3Institut für Pathologie, Universitätsklinikum Aachen
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Publication History

Publication Date:
10 October 2003 (online)

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Zusammenfassung

Studienziel: Die Intention dieser Studie war die Untersuchung der FDG-PET hinsichtlich ihrer diagnostischen Wertigkeit zum Nachweis einer septischen bzw. aseptischen Hüftendoprothesenlockerung. Methode: 28 Patienten mit 41 Hüftendoprothesen wurden präoperativ mittels FDG-PET bei klinischem Verdacht auf eine septische bzw. aseptische Hüftendoprothesenlockerung untersucht. Im Rahmen der diagnostischen Befundung der FDG-PET wurde ein differenziertes Interpretationsmuster unterteilt in 5 Kategorien entwickelt. Die endgültige Diagnosesicherung erfolgte in allen Fällen durch die operative Intervention mit histologischer respektiver immunhistochemischer Gewebeaufarbeitung. Ergebnisse: Die erarbeiteten Befundkategorien I - V zeigten eine hohe Übereinstimmung mit den intraoperativen makroskopischen und histologischen Befunden (n = 23 richtig positive, n = 1 falsch positive, n = 1 richtig negative und n = 3 falsch negative). Schlussfolgerung: Anhand einer differenzierten Interpretation des qualitativen Glukosemetabolismus (Befundkategorien I - V) lassen sich sichere Aussagen über septische/aseptische Endoprothesenlockerungen machen. Dieses wurde eindrucksvoll durch die Übereinstimmung der FDG-Befunde mit den postoperativ erhobenen histologischen Befunden bestätigt.

Abstract

Aim: The purpose of this study was to examine the FDG-PET in respect of its diagnostic valency with regard to septic/aseptic loosening of lower limb prostheses. Method: 28 patients with 41 lower limb prostheses were examined by means of FDG-PET to evaluate septic/aseptic loosening of their hip prostheses. Therefore, a differentiated FDG-PET result interpretation subdivided into five categories was developed. The final diagnosis was based on operative findings with following culture and histological outcome. Results: The worked-out categories showed a high agreement to the intraoperative macroscopic and histological results (n = 23 correctly positive, n = 1 false positive, n = 1 correctly negative and n = 3 false negative). Conclusion: With a subtly differentiated interpretation (categories I - V) of the qualitative glucose metabolism safe statements can be made regarding septic/aseptic endoprostheses loosening. This was impressively confirmed by the agreement of the FDG results with the histological results.

Schlüsselwörter

FDG-PET - Endoprothesenlockerung - Infektion - Polyethylenabrieb

Key words

FDG-PET - loosening - endoprostheses - infection - wear of polyethylene

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Dr. med. Torsten Mumme

UK Aachen, Orthopädische Klinik

Pauwelsstraße 30

52074 Aachen

Phone: + 49-241-80-89410

Fax: + 49-241-80-82453

Email: Torsten.Mumme@gmx.de

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