Diagnostic value of 99mTc-HMPAO-labeled leukocytes scintigraphy in suspicion of post-sternotomy mediastinitis relapse View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-10-08

AUTHORS

François Rouzet, Claire de Labriolle-Vaylet, Jean-Louis Trouillet, Anne Hitzel, Khadija Benali, Rachida Lebtahi, Dominique Le Guludec

ABSTRACT

BackgroundThe diagnostic value of radiolabeled white blood cells (WBCs) scintigraphy in mediastinitis is well established, but data in the specific context of relapse are lacking. The present study aimed at evaluation of the diagnostic value of WBCs scintigraphy in suspicion of mediastinitis relapse after prior surgical revision.Methods and ResultsMultiple planar incidences of the chest were acquired 4 and 20 hours after injection of labeled WBC in 43 patients. In case of non-conclusive scintigraphy, a second scan was performed 2-3 weeks after the first one. The diagnosis of infection was based on positive bacteriological results; otherwise patients were followed up for at least 1 year. Out of 39 analyzable patients, 17 (44%) were diagnosed with mediastinitis relapse. After the first scan, 32 of 39 were correctly classified, 2 were false positive, and 5 were not conclusive. After completion of an additional scan in the latter 5 patients, 36 of 39 were correctly classified and 3 were false positive (100% sensitivity, 86% specificity, 85% positive predictive value, and 100% negative predictive value).ConclusionsIn the specific context of suspicion of mediastinitis relapse, the optimal diagnostic value was achieved by repeating the scan when the first one was not conclusive. In this context, a negative WBC scintigraphy was able to rule out infection, with potential major impact on therapeutic management in patients with poor clinical status. More... »

PAGES

123-129

References to SciGraph publications

  • 2005-07-01. Successful long-term program for controlling methicillin-resistant Staphylococcus aureus in intensive care units in INTENSIVE CARE MEDICINE
  • 2000-05. Sternal wound infection revisited in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
  • 2010-03-03. Guidelines for the labelling of leucocytes with 99mTc-HMPAO in EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
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    http://scigraph.springernature.com/pub.10.1007/s12350-014-9999-9

    DOI

    http://dx.doi.org/10.1007/s12350-014-9999-9

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1050821479

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/25287738


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