Three phase bone scintigraphy in diagnosis of periprosthetic artificial joint infection / 中国医学影像技术

ABSTRACT

Objective: To explore the value of three phase bone scintigraphy (TPBS) in diagnosis of periprosthetic joint infection (PJI) after artificial joint replacement (AJR). Methods: TPBS data of 236 patients with 324 joints after AJR were retrospectively analyzed, including 120 joints (48 hips, 72 knees) in PJI group, 119 joints (75 hips, 44 knees) in aseptic loosening group and 85 joints (28 hips, 57 knees) in control group. The uptake of imaging agent around prosthesis was analyzed with visual and semi-quantitative methods. The diagnostic values of different visual judgment criteria for PJI were evaluated according to final clinical diagnosis, and blood pool phases were compared among different groups with semi-quantitative analysis to obtain the best diagnostic threshold and evaluate the diagnostic efficiency. Results: The accuracy rate of abnormal uptake in diagnosis of hip joint infection was higher than that of knee joint infection (92.68% vs 65.51%, P0.05). TBR of knee joint in PJI group was higher than that in aseptic loosening group and control group (both P<0.001), and in aseptic loosening group was higher than in control group (P<0.001). Taken TBR≥1.44 as the threshold, the diagnostic accuracy for PJI of knee joint was 91.38%. Conclusion: TPBS could be used to diagnose PJI after AJR. The visual judgment of TPBS had high accuracy in diagnosis of hip prosthesis infection, whereas combining with semi-quantitative analysis was necessary for judging knee prosthesis infection.