The AMANDUS project part II

• Verfasst von: Doll, Julian [VerfasserIn]
• Verfasst von: Streblow, Jan [VerfasserIn]
• Verfasst von: Weber, Marc-André [VerfasserIn]
• Verfasst von: Schmidmaier, Gerhard [VerfasserIn]
• Verfasst von: Fischer, Christian [VerfasserIn]
• Titel: The AMANDUS project part II
• Titelzusatz: advanced microperfusion assessed non-union diagnostics with Contrast-Enhanced Ultrasound (CEUS) : a reliable diagnostic tool for the management and pre-operative detection of infected upper-limb non-unions
• Verf.angabe: Julian Doll, Jan Streblow, Marc-André Weber, Gerhard Schmidmaier, and Christian Fischer
• Jahr: 2021
• Umfang: 10 S.
• Fussnoten: Online verfügbar: 17. Dezember 2020 ; Gesehen am 30.03.2021
• Titel Quelle: Enthalten in: Ultrasound in medicine & biology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1973
• Jahr Quelle: 2021
• Band/Heft Quelle: 47(2021), 3 vom: März, Seite 478-487
• ISSN Quelle: 1879-291X
• DOI: doi:10.1016/j.ultrasmedbio.2020.11.028
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: CEUS
• Sach-SW: Contrast-enhanced ultrasound
• Sach-SW: Infection
• Sach-SW: Musculoskeletal
• Sach-SW: Non-union
• Sach-SW: Perfusion
• Sach-SW: Upper limb
• K10plus-PPN: 1752821815

Abstract

The management of upper-limb non-unions can be challenging, especially when infection is existent. Thus, pre-operative detection of infection plays a relevant 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 differentiating between aseptic and infected upper-limb non-unions. Osseous perfusion of 50 upper-extremity non-unions (radius/ulna, n=20; humerus, n=22; clavicle, n=8) was prospectively assessed with CEUS before revision surgery. The perfusion was quantified via time-intensity curves and peak enhancement (in arbitrary units). Significant perfusion differences between aseptic and infected non-unions could be detected (peak enhancement, p < 0.001). The sensitivity and specificity for the detection of infected upper-limb non-unions were 80% and 94.3% (cutoff peak enhancement: 130.8 arbitrary units). CEUS reliably differentiates between aseptic and infected upper-limb non-unions. Consequently, CEUS should be integrated into the daily diagnostic routine algorithm to plan non-union revision surgery more precisely as a single- or multi-step procedure.