氟-18正电子发射型断层扫描在植入式心血管电子装置感染诊断中的应用  

Application of fluorine-18 positron emission tomography and computed tomography in diagnosis of cardiovascular implantable electronic device Infection

作　　者：田轶伦[1,2] 王龙[1] 李原[1] 李学斌[1] 李鼎[1] 段江波[1] 郭飞[1,2] 昃峰[1] 苑翠珍[1] 谭学瑞[2] 

机构地区：[1]北京大学人民医院心脏中心,北京100044 [2]汕头大学医学院第一附属医院

出　　处：《中国心脏起搏与心电生理杂志》2015年第5期449-453,共5页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：科技部国家科技支撑计划(项目编号:2014BAI11B08)

摘　　要：目的探讨氟-18正电子发射型断层扫描(18F PET-CT)在植入式心血管电子装置(CIED)感染病例诊断中的应用价值。方法入选2013年1月至2014年6月就诊于本中心初步诊断为CIED感染的患者。对于根据症状、常规血培养、心脏超声检查无法明确诊断者,进一步接受PET-CT检查,以明确诊断及分型。然后,根据诊断分别进行针对性治疗,随访一年,观察PET-CT对CIED感染诊断的准确率。结果 2013年1月至2014年6月就诊于本中心初步诊断为CIED感染的患者共227例。其中,10例患者伴有明显症状,但通过常规血培养、心脏超声等检查仍无法明确诊断及分型,其中8例疑似感染性心内膜炎(IE),2例疑似囊袋感染。进而接受PET-CT检查。结果表明,经PET-CT检查后发现,3例患者不存在局部及系统感染,1例疑似IE患者为菌血症,另1例超声见可疑团块的疑似IE患者为电极拔除术后残留组织。结果表明,在本研究中的10例疑似诊断患者中,经PET-CT诊断确诊处理后,随访一年,10例均未出现新增感染及感染复发。结论在常规临床检查无法确诊的疑似CIED感染患者中,PET-CT可作为确定诊断方法。Objective This study evaluated the usefulness of fluorodesoxyglucose marked by fluorine-18 （18F-FDG） positron emission tomography （PET） and computed tomography （CT） in patients with suspected cardiovascular implantable electronic device （CIED） infection. Methods From Jan 2013 to Jun 2014, patients treated for CIED infection in our center were enrolled. The patients, suspected as CIED infection without confirm evidence from symptom, blood culture, echocardiography, underwent 18F-FDG PET/CT. Post 1 year follow up, analysis the accuracy of diagnosis depended on18F-FDG PET/CT. Result From Jan 2013 to Jun 2014, there were 227 patients treated for CIED infection in our cen- ter. 10 of 227 cases was suspected as CIED infection without confirm evidence from symptom, blood culture, echocardio- graphy. Eight were suspected as infective endocarditis （IE）, 2 as pocket infection. The results of 18F-FDG PET/CT sug- gested no infection in 2 patients with suspected pocket infection, 1 with suspected IE. One patient with suspected IE was diagnosed as bacteremia. 1 patient with vegetation, suspected IE, was diagnosed as no infection. All of the cases received standard treatment based on 18F-FDG PET/CT. Post follow up of 1 year, there were no recurrence and new infection ca- ses. Conclusions PET/CT is useful in diagnosis of CIED infection and classification.

关 键 词：心血管病学 植入式心血管电子装置 感染 正电子发射型断层扫描 诊断 

分 类 号：R734.2[医药卫生—肿瘤]