18F－FDG PET/CT在疑诊起搏器置入相关感染的定位及病因学诊断中的应用  

Localization and etiologic diagnosis of suspected pacemaker-related infection with 18F-FDG PET/CT

作　　者：李原[1] 王茜[1] 王龙[2] 

机构地区：[1]北京大学人民医院核医学科,100044 [2]北京大学人民医院心脏中心心血管内科,100044

出　　处：《中华核医学与分子影像杂志》2017年第5期284-288,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的评价18F－FDG PET/CT在疑诊起搏器置入相关感染的定位及病因学诊断中的临床应用价值。方法回顾性分析15例（男10例，女5例，年龄45～86岁）因临床疑诊起搏器置入相关感染行18F－FDG PET/CT显像患者的资料，观察起搏器走行区是否有异常FDG摄取，同时观察全身其他部位有无异常FDG浓聚并判断病灶性质。与最终临床诊断对照，评价18F－FDG PET/CT对起搏器置入相关感染的诊断效能。结果在7例疑诊有囊袋区感染者中，5例经PET/CT检出囊袋区感染灶，分别位于皮下和（或）深层软组织；在9例疑诊感染性心内膜炎者中，3例经PET/CT发现呈现左心房和（或）右心房、室肌壁弥漫性FDG摄取增高，3例见导线走行区外的全身多发FDG摄取增高灶，另3例PET/CT阴性。PET/CT正确诊断或排除囊袋区感染7例，正确诊断或排除感染性心内膜炎8例，正确诊断感染存在并明确是否与起搏器置入相关14例。结论18F－FDG PET/CT显像对疑诊起搏器置入术后感染的定位及病因学诊断具有较高的价值，值得临床推广应用。ObjectiveTo evaluate the clinical significance of 18F-FDG PET/CT in localization and etiologic diagnosis of suspected pacemaker-related infection（SPRI）.MethodsFifteen SPRI patients （10 males, 5 females, age range： 45-86 years） were included in this retrospectively study. 18F-FDG uptake in device-related region and abnormal 18F-FDG uptake out of the device region were visually interpreted. Final diagnosis was decided according to modified Duke′s criteria and imaging interpretation. Diagnostic efficiency of 18F-FDG PET/CT on SPRI was evaluated.ResultsOf 7 patients with suspected pocket infection, 5 patients had hot spot of 18F-FDG in the pocket site, either in superficial skin and/or deep soft tissue. Of 9 patients with suspected infective endocarditis, a diffuse FDG uptake was demonstrated in 3 patients in the area of left atrium, right atrium, and right ventricle; another 3 patients had abnormal FDG uptake in other sites rather than in the implantation regions, and the rest 3 showed negative PET/CT results. In patients with SPRI, 18F-FDG PET/CT diagnosed 7 cases of pocket infection, 8 cases of infective endocarditis, 14 cases of pacemaker-related infection.Conclusions18F-FDG PET/CT imaging is useful in localization and etiologic diagnosis in SPRI patients. It might guide the clinical SPRI management.

关 键 词：心脏起博器 人工 感染 正电子发射断层显像术 体层摄影术 x线计算机 脱氧葡萄糖 

分 类 号：R541.7[医药卫生—心血管疾病] R817.4[医药卫生—内科学]