masterThesis
Osteomielitis esternal: utilidad de las pruebas de diagnóstico por imágenes con enfoque en medicina nuclear
Fecha
2015Autor
Carofilis-Mendoza, Franklin-Moisés
Marín-Oyaga, Víctor-Andrés
Institución
Resumen
Introduction: The diagnosis of sternal osteomyelitis post-sternotomy is difficult using clinical or laboratory symptoms and morphological images more oriented to suspect the diagnosis. Early diagnosis offers quality of life and the best treatment to reduce mortality of between 14% and 47%. Labelled white cell scintigraphy provides the best diagnostic performance for infections and stands out as the diagnostic gold standard. Objective: To identify the performance and usefulness of scintigraphy using labeled leukocytes with 99mTc-HMPAO in studies for the evaluation of sternal osteomyelitis. Methods: A retrospective descriptive study of diagnostic test in Bogota Cardioinfantil Foundation between January/2010 and May/2015 scans were performed evaluating radiolabeled autologous leukocytes in suspected osteomyelitis after sternotomy. Results: 52 patients were evaluated, in which leukocyte scintigraphy showed 23 patients (44.2%) with sternal osteomyelitis, achieving a sensitivity and specificity of 88.46% and 100% respectively. The positive predictive value was 100% and the negative predictive value was 89.66%. The impact of a negative test did not change the initial medical management in 93% of cases while the modified test positive in 83%. Conclusions: The scintigraphy with radiolabeled autologous leukocytes with 99mTc-HMPAO remains the gold standard of reference for the non-invasive diagnosis of osteomyelitis, and in the case of sternal osteomyelitis proof becomes relevant choice in the selection of patients who warrant surgical re-intervention.