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Verfasst von:Fischer, Christian [VerfasserIn]   i
 Preuß, Eva-Maria [VerfasserIn]   i
 Tanner, Michael Christopher [VerfasserIn]   i
 Bruckner, Thomas [VerfasserIn]   i
 Krix, Martin [VerfasserIn]   i
 Amarteifio, Erick [VerfasserIn]   i
 Miska, Matthias [VerfasserIn]   i
 Moghaddam-Alvandi, Arash [VerfasserIn]   i
 Schmidmaier, Gerhard [VerfasserIn]   i
 Weber, Marc-André [VerfasserIn]   i
Titel:Dynamic contrast-enhanced sonography and dynamic contrast-enhanced magnetic resonance imaging for preoperative diagnosis of infected nonunions
Verf.angabe:Christian Fischer, MD, Eva-Maria Preuβ, MD, Michael Tanner, MD, Thomas Bruckner, PhD, Martin Krix, MD, Erick Amarteifio, MD, Matthias Miska, MD, Arash Moghaddam-Alvandi, MD, Gerhard Schmidmaier, MD, Marc-André Weber, MD
E-Jahr:2016
Jahr:1 April 2016
Umfang:10 S.
Fussnoten:Gesehen am 12.09.2019
Titel Quelle:Enthalten in: Journal of ultrasound in medicine
Ort Quelle:Hoboken, NJ : Wiley, 1982
Jahr Quelle:2016
Band/Heft Quelle:35(2016), 5, Seite 933-942
ISSN Quelle:1550-9613
Abstract:Objectives Bone regeneration depends on perfusion of the fracture tissue, whereby hypervascularity is associated with infection, which itself causes nonunions. To date, nonunion perfusion has not been assessed with contrast-enhanced sonography. The aim of this study was to evaluate the potential of contrast-enhanced sonography in the analysis of nonunion tissue perfusion. Methods Nonunion vascularity of 31 patients before revision surgery was prospectively examined with qualitative contrast-enhanced sonography and dynamic contrast-enhanced magnetic resonance imaging (MRI). Time-intensity curves from 2-minute contrast-enhanced sonographic video clips were generated, and parameters such as wash-in rate, rise time, and peak enhancement were quantified. On dynamic contrast-enhanced MRI, the initial area under the enhancement curve was quantified. Preoperative radiographs, computed tomograms, the clinical nonunion score, laboratory infection features, as well as contrast-enhanced sonographic and dynamic contrast-enhanced MRI perfusion were correlated with microbiological results from the nonunion tissue. Results Both qualitative and quantitative contrast-enhanced sonography showed significant differences between infected and aseptic nonunions (P = .015 and .020). The qualitative dynamic contrast-enhanced MRI analysis was not significant (P= .244), but after quantification, a strong correlation (P = .007) with microbiological results was noted. A receiver operating characteristic analysis calculated ideal cutoff values for quantitative contrast-enhanced sonography and dynamic contrast-enhanced MRI so that their combination detected infected nonunions with sensitivity and specificity of 88.9% and 77.3%, respectively. Clinical, radiologic, and laboratory examinations did not correlate with microbiological results (P > .05). Conclusions Contrast-enhanced sonography can visualize the vascularity of nonunions in real time, while quantification software allows for a semiobjective evaluation of bone perfusion. The correlations of both quantitative contrast-enhanced sonography and dynamic contrast-enhanced MRI with microbiological results show their high value for differentiation of infected from aseptic nonunions.
DOI:doi:10.7863/ultra.15.06107
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext ; Verlag: https://doi.org/10.7863/ultra.15.06107
 Volltext: https://onlinelibrary.wiley.com/doi/abs/10.7863/ultra.15.06107
 DOI: https://doi.org/10.7863/ultra.15.06107
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:contrast-enhanced sonography
 dynamic contrast-enhanced magnetic resonance imaging
 infection
 musculoskeletal ultrasound
 nonunion
 perfusion
 quantification
K10plus-PPN:1676814272
Verknüpfungen:→ Zeitschrift

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