Detection of abdominal aortic graft infection: comparison of magnetic resonance imaging and indium-labeled white blood cell scanning.
Identifieur interne : 002779 ( Main/Exploration ); précédent : 002778; suivant : 002780Detection of abdominal aortic graft infection: comparison of magnetic resonance imaging and indium-labeled white blood cell scanning.
Auteurs : RBID : pubmed:17823040English descriptors
- KwdEn :
- Aged, Aorta, Abdominal (surgery), Biocompatible Materials, Blood Vessel Prosthesis (adverse effects), False Negative Reactions, False Positive Reactions, Female, Femoral Artery (surgery), Follow-Up Studies, Humans, Iliac Artery (surgery), Indium Radioisotopes (diagnostic use), Magnetic Resonance Imaging, Male, Neutrophils, Polyethylene Terephthalates, Polytetrafluoroethylene, Predictive Value of Tests, Prosthesis-Related Infections (diagnosis), Prosthesis-Related Infections (radionuclide imaging), Radiopharmaceuticals (diagnostic use), Retrospective Studies, Single-Blind Method, Survival Rate, Whole Body Imaging (methods).
- MESH :
- chemical , diagnostic use : Indium Radioisotopes, Radiopharmaceuticals.
- chemical : Biocompatible Materials, Polyethylene Terephthalates, Polytetrafluoroethylene.
- adverse effects : Blood Vessel Prosthesis.
- diagnosis : Prosthesis-Related Infections.
- methods : Whole Body Imaging.
- radionuclide imaging : Prosthesis-Related Infections.
- surgery : Aorta, Abdominal, Femoral Artery, Iliac Artery.
- Aged, False Negative Reactions, False Positive Reactions, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Neutrophils, Predictive Value of Tests, Retrospective Studies, Single-Blind Method, Survival Rate.
Abstract
Infected abdominal aortic grafts rank as one of the most severe complications of vascular surgery, with high mortality and morbidity. The incidence of infection after prosthetic aortic reconstruction is 1-3%. Diagnosis of vascular graft infection can be occasionally difficult. Clinical manifestations and assessment of the extent of graft infection are usually nonspecific, and their detection by radiographic methods, such as computed tomography (CT), magnetic resonance imaging (MRI), and leukocyte -imaging, can be difficult. The purpose of this study was to evaluate the predictive value (PV) of indium-111-labeled white blood cell scanning (WBCS) and MRI in patients who were suspected of having intracavitary vascular graft infection (IGF). The study was done as a cross-control retrospective, single-center study. Fifty-eight In-111-labeled WBC scans and 59 MRIs were performed in suspected patients between January 1995 and January 2005. Among the 40 suspected patients, 35 cases of aorta graft infection were identified intraoperatively. The diagnosis of IGF was based on clinical signs, microbiological and histological examination, MRI and leukocyte imaging, and lack of graft incorporation with surrounding fluid observed intraoperatively. The positive PV (PPV) of MRI was 95% (95% confidence interval [CI] 84-105%) compared to In-111-labeled WBCS, which was 80% (95% CI 62-96%). The negative PV (NPV) of MRI was 80% (95% CI 68-92%) compared to 82% (95% CI 69-94%) for In-111-labeled WBCS. MRI showed a nonsignificant but better PPV for detecting IGF compared to In-111 leukocyte imaging. The NPVs for MRI and In-111-labeled WBCS were very near each other, with a very small advantage for In-111-WBCS. This comparison study suggested MRI as a primary diagnostic modality to investigate patients suspected of having aortic graft infections before In-111-labeled WBCS.
DOI: 10.1016/j.avsg.2007.03.018
PubMed: 17823040
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Detection of abdominal aortic graft infection: comparison of magnetic resonance imaging and indium-labeled white blood cell scanning.</title><author><name sortKey="Shahidi, Saeid" uniqKey="Shahidi S">Saeid Shahidi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus/Skejby, Aarhus/Skejby, Denmark. saeid_shahidi@hotmail.com</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus/Skejby, Aarhus/Skejby</wicri:regionArea></affiliation></author><author><name sortKey="Eskil, Anni" uniqKey="Eskil A">Anni Eskil</name></author><author><name sortKey="Lundof, Erik" uniqKey="Lundof E">Erik Lundof</name></author><author><name sortKey="Klaerke, Anette" uniqKey="Klaerke A">Anette Klaerke</name></author><author><name sortKey="Jensen, Bent Skov" uniqKey="Jensen B">Bent Skov Jensen</name></author></titleStmt><publicationStmt><date when="2007">2007</date><idno type="doi">10.1016/j.avsg.2007.03.018</idno><idno type="RBID">pubmed:17823040</idno><idno type="pmid">17823040</idno><idno type="wicri:Area/Main/Corpus">002672</idno><idno type="wicri:Area/Main/Curation">002672</idno><idno type="wicri:Area/Main/Exploration">002779</idno></publicationStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aorta, Abdominal (surgery)</term><term>Biocompatible Materials</term><term>Blood Vessel Prosthesis (adverse effects)</term><term>False Negative Reactions</term><term>False Positive Reactions</term><term>Female</term><term>Femoral Artery (surgery)</term><term>Follow-Up Studies</term><term>Humans</term><term>Iliac Artery (surgery)</term><term>Indium Radioisotopes (diagnostic use)</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Neutrophils</term><term>Polyethylene Terephthalates</term><term>Polytetrafluoroethylene</term><term>Predictive Value of Tests</term><term>Prosthesis-Related Infections (diagnosis)</term><term>Prosthesis-Related Infections (radionuclide imaging)</term><term>Radiopharmaceuticals (diagnostic use)</term><term>Retrospective Studies</term><term>Single-Blind Method</term><term>Survival Rate</term><term>Whole Body Imaging (methods)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="diagnostic use" xml:lang="en"><term>Indium Radioisotopes</term><term>Radiopharmaceuticals</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Biocompatible Materials</term><term>Polyethylene Terephthalates</term><term>Polytetrafluoroethylene</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Blood Vessel Prosthesis</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Prosthesis-Related Infections</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Whole Body Imaging</term></keywords><keywords scheme="MESH" qualifier="radionuclide imaging" xml:lang="en"><term>Prosthesis-Related Infections</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Aorta, Abdominal</term><term>Femoral Artery</term><term>Iliac Artery</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>False Negative Reactions</term><term>False Positive Reactions</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Neutrophils</term><term>Predictive Value of Tests</term><term>Retrospective Studies</term><term>Single-Blind Method</term><term>Survival Rate</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Infected abdominal aortic grafts rank as one of the most severe complications of vascular surgery, with high mortality and morbidity. The incidence of infection after prosthetic aortic reconstruction is 1-3%. Diagnosis of vascular graft infection can be occasionally difficult. Clinical manifestations and assessment of the extent of graft infection are usually nonspecific, and their detection by radiographic methods, such as computed tomography (CT), magnetic resonance imaging (MRI), and leukocyte -imaging, can be difficult. The purpose of this study was to evaluate the predictive value (PV) of indium-111-labeled white blood cell scanning (WBCS) and MRI in patients who were suspected of having intracavitary vascular graft infection (IGF). The study was done as a cross-control retrospective, single-center study. Fifty-eight In-111-labeled WBC scans and 59 MRIs were performed in suspected patients between January 1995 and January 2005. Among the 40 suspected patients, 35 cases of aorta graft infection were identified intraoperatively. The diagnosis of IGF was based on clinical signs, microbiological and histological examination, MRI and leukocyte imaging, and lack of graft incorporation with surrounding fluid observed intraoperatively. The positive PV (PPV) of MRI was 95% (95% confidence interval [CI] 84-105%) compared to In-111-labeled WBCS, which was 80% (95% CI 62-96%). The negative PV (NPV) of MRI was 80% (95% CI 68-92%) compared to 82% (95% CI 69-94%) for In-111-labeled WBCS. MRI showed a nonsignificant but better PPV for detecting IGF compared to In-111 leukocyte imaging. The NPVs for MRI and In-111-labeled WBCS were very near each other, with a very small advantage for In-111-WBCS. This comparison study suggested MRI as a primary diagnostic modality to investigate patients suspected of having aortic graft infections before In-111-labeled WBCS.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">17823040</PMID><DateCreated><Year>2007</Year><Month>09</Month><Day>07</Day></DateCreated><DateCompleted><Year>2007</Year><Month>12</Month><Day>06</Day></DateCompleted><Article PubModel="Print"><Journal><ISSN IssnType="Print">0890-5096</ISSN><JournalIssue CitedMedium="Print"><Volume>21</Volume><Issue>5</Issue><PubDate><Year>2007</Year><Month>Sep</Month></PubDate></JournalIssue><Title>Annals of vascular surgery</Title><ISOAbbreviation>Ann Vasc Surg</ISOAbbreviation></Journal><ArticleTitle>Detection of abdominal aortic graft infection: comparison of magnetic resonance imaging and indium-labeled white blood cell scanning.</ArticleTitle><Pagination><MedlinePgn>586-92</MedlinePgn></Pagination><Abstract><AbstractText>Infected abdominal aortic grafts rank as one of the most severe complications of vascular surgery, with high mortality and morbidity. The incidence of infection after prosthetic aortic reconstruction is 1-3%. Diagnosis of vascular graft infection can be occasionally difficult. Clinical manifestations and assessment of the extent of graft infection are usually nonspecific, and their detection by radiographic methods, such as computed tomography (CT), magnetic resonance imaging (MRI), and leukocyte -imaging, can be difficult. The purpose of this study was to evaluate the predictive value (PV) of indium-111-labeled white blood cell scanning (WBCS) and MRI in patients who were suspected of having intracavitary vascular graft infection (IGF). The study was done as a cross-control retrospective, single-center study. Fifty-eight In-111-labeled WBC scans and 59 MRIs were performed in suspected patients between January 1995 and January 2005. Among the 40 suspected patients, 35 cases of aorta graft infection were identified intraoperatively. The diagnosis of IGF was based on clinical signs, microbiological and histological examination, MRI and leukocyte imaging, and lack of graft incorporation with surrounding fluid observed intraoperatively. The positive PV (PPV) of MRI was 95% (95% confidence interval [CI] 84-105%) compared to In-111-labeled WBCS, which was 80% (95% CI 62-96%). The negative PV (NPV) of MRI was 80% (95% CI 68-92%) compared to 82% (95% CI 69-94%) for In-111-labeled WBCS. MRI showed a nonsignificant but better PPV for detecting IGF compared to In-111 leukocyte imaging. The NPVs for MRI and In-111-labeled WBCS were very near each other, with a very small advantage for In-111-WBCS. This comparison study suggested MRI as a primary diagnostic modality to investigate patients suspected of having aortic graft infections before In-111-labeled WBCS.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Shahidi</LastName><ForeName>Saeid</ForeName><Initials>S</Initials><Affiliation>Department of Cardiothoracic and Vascular Surgery, University Hospital Aarhus/Skejby, Aarhus/Skejby, Denmark. saeid_shahidi@hotmail.com</Affiliation></Author><Author ValidYN="Y"><LastName>Eskil</LastName><ForeName>Anni</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Lundof</LastName><ForeName>Erik</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Klaerke</LastName><ForeName>Anette</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Jensen</LastName><ForeName>Bent Skov</ForeName><Initials>BS</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType>Comparative Study</PublicationType><PublicationType>Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Ann Vasc Surg</MedlineTA><NlmUniqueID>8703941</NlmUniqueID><ISSNLinking>0890-5096</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance>Biocompatible Materials</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance>Indium Radioisotopes</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance>Polyethylene Terephthalates</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance>Radiopharmaceuticals</NameOfSubstance></Chemical><Chemical><RegistryNumber>9002-84-0</RegistryNumber><NameOfSubstance>Polytetrafluoroethylene</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Aorta, Abdominal</DescriptorName><QualifierName MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Biocompatible Materials</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Blood Vessel Prosthesis</DescriptorName><QualifierName MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">False Negative Reactions</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">False Positive Reactions</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Femoral Artery</DescriptorName><QualifierName MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Iliac Artery</DescriptorName><QualifierName MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Indium Radioisotopes</DescriptorName><QualifierName MajorTopicYN="Y">diagnostic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y">Magnetic Resonance Imaging</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Neutrophils</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Polyethylene Terephthalates</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Polytetrafluoroethylene</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Predictive Value of Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Prosthesis-Related Infections</DescriptorName><QualifierName MajorTopicYN="Y">diagnosis</QualifierName><QualifierName MajorTopicYN="N">radionuclide imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Radiopharmaceuticals</DescriptorName><QualifierName MajorTopicYN="Y">diagnostic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Single-Blind Method</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Survival Rate</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N">Whole Body Imaging</DescriptorName><QualifierName MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate 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