technetium-tc-99m-exametazime and Fractures--Bone

White blood cell (WBC) scintigraphy for diagnosing fracture-related infections (FRIs) has only been investigated in small patient series. Aims of this study were (1) to establish the accuracy of WBC scintigraphy for diagnosing FRIs, and (2) to investigate whether the duration of the time interval between surgery and WBC scintigraphy influences its accuracy.. 192 consecutive WBC scintigraphies with. WBC scintigraphy had a sensitivity of 0.79, a specificity of 0.97, a positive predicting value of 0.91, a negative predicting value of 0.93 and a diagnostic accuracy of 0.92 for detecting an FRI in the peripheral skeleton. The duration of the interval between surgery and the WBC scintigraphy did not influence its diagnostic accuracy; neither did concomitant use of antibiotics or NSAIDs. There were 11 patients with a false-negative (FN) WBC scintigraphy, the majority of these patients (n = 9, 82%) suffered from an infected nonunion. Four patients had a false-positive (FP) WBC scintigraphy.. WBC scintigraphy showed a high diagnostic accuracy (0.92) for detecting FRIs in the peripheral skeleton. Duration of the time interval between surgery for the initial injury and the WBC did not influence the results which indicate that WBC scintigraphy is accurate shortly after surgery.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Diseases, Infectious; Female; Fracture Fixation; Fractures, Bone; Humans; Image Interpretation, Computer-Assisted; Leukocytes; Male; Middle Aged; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Sensitivity and Specificity; Soft Tissue Infections; Technetium Tc 99m Exametazime; Young Adult

Topics: Accidents, Traffic; Adult; Female; Fractures, Bone; Gallium Radioisotopes; Humans; Leukocytes; Ossification, Heterotopic; Radionuclide Imaging; Radiopharmaceuticals; Sepsis; Technetium Tc 99m Exametazime

Bone marrow scintigrams obtained 2-6 h and/or 20-24 h after injection of 99Tcm-HMPAO-labelled leucocytes (LeuSc) in 16 patients (seven males, nine females, average age 57 years, either with benign or malignant haemopathy, or with benign or metastatic skeletal diseases) have been compared to corresponding pictures obtained 20 min after injection of 99Tcm-labelled human serum albumin nanosized colloids (NanSc, performed within a week thereafter). Overall distribution of the colloids and of the labelled leukocytes at the level of the bone marrow appeared to be the same. Fresh vertebral fractures as well as metastatic lesions of the axial skeleton appeared as cold defects in both investigations. Fractures of the ribs as well as one metastatic lesion involving one trochanter could not be identified. Although all seven lesions involving Th9 to L4 could be clearly investigated with LeuSc, only three could be recognized with NanSc. It is concluded that, in patients with cancerous diseases, LeuSc is better than NanSc in demonstrating lesions in the case of dubious conventional osseous scintigrams as well as in the case of neurological or skeletal symptoms at the level of the lumbar and/or low thoracic regions.

Topics: Bone Diseases; Bone Marrow; Bone Neoplasms; Female; Fractures, Bone; Humans; Leukocytes; Male; Middle Aged; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Exametazime