Contrast-enhanced ultrasound

• Verfasst von: Doll, Julian [VerfasserIn]
• Verfasst von: Waizenegger, Stefan [VerfasserIn]
• Verfasst von: Schmidmaier, Gerhard [VerfasserIn]
• Verfasst von: Weber, Marc-André [VerfasserIn]
• Verfasst von: Fischer, Christian [VerfasserIn]
• Titel: Contrast-enhanced ultrasound
• Titelzusatz: a viable diagnostic tool in predicting treatment failure after non-union revision surgery for upper- and lower-limb non-unions
• Verf.angabe: Julian Doll, Stefan Waizenegger, Gerhard Schmidmaier, Marc-André Weber, and Christian Fischer
• E-Jahr: 2021
• Jahr: 22 August 2021
• Umfang: 12 S.
• Fussnoten: Gesehen am 15.12.2021
• Titel Quelle: Enthalten in: Ultrasound in medicine & biology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1973
• Jahr Quelle: 2021
• Band/Heft Quelle: 47(2021), 11, Seite 3147-3158
• ISSN Quelle: 1879-291X
• DOI: doi:10.1016/j.ultrasmedbio.2021.07.020
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Bone regeneration
• Sach-SW: Contrast-enhanced ultrasound
• Sach-SW: Musculoskeletal
• Sach-SW: Non-union
• Sach-SW: Perfusion
• Sach-SW: Revision surgery
• K10plus-PPN: 1782247467

Abstract

Non-unions remain a major complication in the treatment of long-bone fractures and affect quality of life considerably. Both early detection and treatment of non-unions are essential to secure subsequent fracture union. Sufficient vascularization plays a key role in the healing process. The aim of this prospective study was to quantify the microperfusion within non-unions by means of contrast-enhanced ultrasound (CEUS) as early as 12 wk after non-union surgery and to examine the prognostic capability of CEUS in predicting treatment failure. Among 112 patients who had undergone non-union surgery, consolidation within 36 mo was achieved in 89 patients (“responders”), whereas 23 patients showed persistent non-unions (“non-responders”) and required further surgery. CEUS quantification parameters such as peak enhancement, wash-in area under the curve and wash-in perfusion index revealed significantly higher perfusion levels in “responders” compared with “non-responders” (p < 0.05). Receiver operator characteristic curve analysis revealed that persistent fracture non-unions could be predicted with a sensitivity/specificity of 88.7%/72.2% in lower-limb non-unions and a sensitivity/specificity of 66.7%/100.0% in upper-limb non-unions. CEUS is a suitable diagnostic tool in predicting treatment failure as early as 12 wk after non-union surgery and should be integrated into the clinical routine when deciding on revision surgery at an early stage.