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目的探讨氟-18正电子发射型断层扫描(18F PET-CT)在植入式心血管电子装置(CIED)感染病例诊断中的应用价值。方法入选2013年1月至2014年6月就诊于本中心初步诊断为CIED感染的患者。对于根据症状、常规血培养、心脏超声检查无法明确诊断者,进一步接受PET-CT检查,以明确诊断及分型。然后,根据诊断分别进行针对性治疗,随访一年,观察PET-CT对CIED感染诊断的准确率。结果 2013年1月至2014年6月就诊于本中心初步诊断为CIED感染的患者共227例。其中,10例患者伴有明显症状,但通过常规血培养、心脏超声等检查仍无法明确诊断及分型,其中8例疑似感染性心内膜炎(IE),2例疑似囊袋感染。进而接受PET-CT检查。结果表明,经PET-CT检查后发现,3例患者不存在局部及系统感染,1例疑似IE患者为菌血症,另1例超声见可疑团块的疑似IE患者为电极拔除术后残留组织。结果表明,在本研究中的10例疑似诊断患者中,经PET-CT诊断确诊处理后,随访一年,10例均未出现新增感染及感染复发。结论在常规临床检查无法确诊的疑似CIED感染患者中,PET-CT可作为确定诊断方法。
Objective To investigate the value of 18F PET-CT in the diagnosis of patients with ICED infection. Methods Selected patients who were initially diagnosed with CIED infection from January 2013 to June 2014 in our center. According to the symptoms, routine blood culture, cardiac ultrasound can not confirm the diagnosis, and further accept the PET-CT examination to confirm the diagnosis and classification. Then, according to the diagnosis of targeted treatment were followed up for one year, PET-CT to observe the diagnostic accuracy of CIED infection. Results From January 2013 to June 2014, 227 patients were initially diagnosed as having ICED in our center. Among them, 10 patients were accompanied by obvious symptoms, but routine blood culture and echocardiography still failed to confirm the diagnosis and classification, including 8 cases of suspected infective endocarditis (IE) and 2 cases of suspected capsular infection. Then accept PET-CT examination. The results showed that there was no local or systemic infection in 3 patients after PET-CT examination, one patient with suspected IE was bacteremia, and the other suspected IE with ultrasound was suspicious mass was residual tissue after electrode extraction . The results showed that in the 10 cases of suspected diagnosis in this study, confirmed by PET-CT diagnosis and treatment, followed up for one year, 10 cases were no new infections and recurrence of infection. Conclusion PET-CT can be used as a definitive diagnostic method in suspected CIED patients who can not be confirmed by routine clinical examination.