Visual assessment of FDG uptake shows a significant correlation with clinical evaluation of disease activity in patients with RA undergoing antiinflammatory treatment.
Combined positron emission tomographic (PET)/computed tomographic (CT) scanners allow the use of CT data for attenuation correction of PET images. Eight patients with cancer underwent PET/CT scanning. Transmission scanning was performed with conventional attenuation correction and with CT scanning during maximum inspiration and normal expiration. Image quality was visually compared and fluorine 18 activities were measured in volumes of interest in the lung and myocardium. Analysis of variance for repeated measures revealed a significant decrease (P =.0001) in measured activities between PET images corrected with CT data acquired during maximum inspiration and those corrected with the conventional attenuation correction method or with CT data acquired during normal expiration. Deep inspiration during CT can result in severe deterioration in the final PET image.
Posttraumatic osteomyelitis is frequently characterized by chronicity and recurrent activation of infection. The diagnosis is usually made on the basis of clinical, laboratory, and imaging examinations. The conventional radiograph is the basic imaging study that provides important information about skeletal deformity, bone quality, identification of metallic implants, and consolidation of the former fracture site. Other imaging techniques are required to determine the grade of activity, to define the extent of infection and to delineate small sequestra, intraosseus fistula and abscesses. A variety of more sophisticated modalities, such as modern cross-sectional imaging and radionuclide studies, are available, and the decision to choose the most suitable method can be very difficult. This review gives an overview of definition, epidemiology, and pathophysiology of chronic posttraumatic osteomyelitis and discusses the value of currently used imaging modalities.
Acute activity in a chronic osteomyelitis can be excluded with high probability if the MRI findings are negative. In the first postoperative year fibrovascular scar cannot be distinguished accurately from reactivated infection on MRI and scintigraphy may improve the accuracy of diagnosis. MRI is more sensitive in low-grade infection during the later course than combined BS/IS. Scintigraphic errors due to ectopic, peripheral, haematopoietic bone marrow can be corrected by MRI.
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