核医学显像在骨折相关性感染中的研究进展

Research Progress of Nuclear Medicine Imaging in Fracture Related Infection

骨折相关性感染是创伤骨科的一种常见且严重并发症,明确诊断是治疗成功的前提,专家共识中提出根据某些临床表现(瘘、窦道或伤口裂开等)即可诊断,但是在临床实践中感染表现较为复杂,仅根据临床表现明确诊断具有挑战性。近年随着技术发展,核医学显像在骨折相关性感染的研究逐渐增多。除较常应用的三时相骨显像外,标记白细胞显像、^(18)F-FDG PET或PET/CT显像也有很高的临床价值,在检出和定位感染灶、评价骨折愈合和内固定及手术计划制订方面具有重要作用。本文就核医学显像对骨折相关性感染的诊断价值及其在骨折相关性感染中的应用研究进展进行综述。

Fracture related infection is a common and serious complication after bone injury.The precondition of successful treatment is definite diagnosis.In the consensus,it was suggested that the diagnosis can be made according to some clinical manifestations,for example fistula,sinus or wound breakdown.But in practice the manifestations are quite variable and complex,it is challenging to make a definite diagnosis based on only confirmatory clinical signs.With the development of imaging techniques,there are more and more researches of nuclear medicine about the application in fracture related infection.Three-phase bone scintigraphy,white blood cell scintigraphy and ^(18)F-FDG PET or PET/CT scan have high diagnostic value and they are important to detect and local infection,to evaluate fracture healing and implant stability,and to visualize anatomic characteristics for surgical planning.This article summarizes the diagnostic value and application of different nuclear medicine imaging in fracture related infection.