The AMANDUS Project

• Verfasst von: Doll, Julian [VerfasserIn]
• Verfasst von: Groß, Sascha [VerfasserIn]
• Verfasst von: Weber, Marc-André [VerfasserIn]
• Verfasst von: Schmidmaier, Gerhard [VerfasserIn]
• Verfasst von: Fischer, Christian [VerfasserIn]
• Titel: The AMANDUS Project
• Titelzusatz: advanced microperfusion assessed non-union diagnostics with contrast-enhanced ultrasound(CEUS) for the detection of infected lower extremity non-unions
• Verf.angabe: Julian Doll, Sascha Gross, Marc-André Weber, Gerhard Schmidmaier, Christian Fischer
• E-Jahr: 2019
• Jahr: 8 May 2019
• Umfang: 8 S.
• Fussnoten: 8 May 2019 ; Gesehen am 05.02.2020
• Titel Quelle: Enthalten in: Ultrasound in medicine & biology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1973
• Jahr Quelle: 2019
• Band/Heft Quelle: 45(2019), 9, Seite 2281-2288
• ISSN Quelle: 1879-291X
• DOI: doi:10.1016/j.ultrasmedbio.2019.05.007
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Contrast-enhanced ultrasound
• Sach-SW: Infection
• Sach-SW: Musculoskeletal
• Sach-SW: Non-union
• Sach-SW: Perfusion
• K10plus-PPN: 1689273941

Abstract

The pre-operative determination of infection plays a decisive role in non-union treatment. This study investigated in a large cohort the diagnostic potential of contrast-enhanced ultrasound (CEUS) as stand-alone method for the differentiation between aseptic and infected non-unions. Of 109 patients with lower extremity non-unions (tibia n=78, femur n=31) osseous perfusion with CEUS was prospectively assessed before revision surgery. The perfusion was quantified via time-intensity curves and peak enhancement (PE) (arbitrary unit [au]). Significant perfusion differences between aseptic and infected non-unions were evident (PE, p < 0.001). The sensitivity and specificity for the detection of infected tibial and femoral non-unions could be determined with 85.1% and 88.7% (cutoff PE: 81.2 au). CEUS illustrates tibial and femoral non-union perfusion in real time and discriminates reliably between aseptic and infected non-unions. Consequently, when CEUS is integrated into the diagnostic routine algorithm, non-union revision surgery can be planned more accurately as a single or multistep procedure.