Computed tomography of the sternum and mediastinum after median sternotomy

Bitkover, Catarina; Cederlund, Kerstin; Aberg, B; Vaage, Jarle

doi:10.1016/s0003-4975(99)00549-4

Cited by 75 publications

(57 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Because of this limitation, a variety of diagnostic approaches to the diagnosis of mediastinitis have been evaluated, including aspiration of the mediastinal space, 14,15 ␣ 1 acid glycoprotein and C-reactive protein measurements, 16 procalcitonin level, 17 and culture of perioperative instruments. 18 Even advanced, expensive methods of radiographic imaging such as computed tomography, 19,20 fluorine-18 fluorodeoxyglucose positron emission tomography, 21,22 gallium-67 scintigraphy, 23 99Tcm-labeled leukocyte scintigraphy, 24,25 or single photon emission computed tomography with 99mTc-hexamethylpropylene amine oxime-labeled leukocytes 26 are either of limited benefit in identifying patients with postoperative mediastinitis or are widely unavailable. For example, the sensitivity and positive predictive value of computed tomography in the diagnosis of mediastinitis were as low as 25% and 71%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…For example, the sensitivity and positive predictive value of computed tomography in the diagnosis of mediastinitis were as low as 25% and 71%, respectively. 19 By contrast, the presence of S aureus bacteremia has high clinical utility (LR Ϸ25). Thus, a simple, inexpensive, and widely available diagnostic test such as blood culture is of great potential benefit to clinicians in identifying the presence of mediastinitis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Staphylococcus aureus Bacteremia After Median Sternotomy

et al. 2003

View full text Add to dashboard Cite

Background-Mediastinitis is a complication of coronary artery bypass graft surgery (CABG) that can be difficult to diagnose. This study evaluated the utility of blood culture results in identifying patients with mediastinitis. Methods and Results-All unique patients undergoing CABG at our institution over a 60-month study period (nϭ5500) and all blood cultures performed on these patients Յ90 days after CABG were identified.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Staphylococcus aureus Bacteremia After Median Sternotomy

et al. 2003

View full text Add to dashboard Cite

show abstract

“…Diagnosis of mediastinitis is frequently established belatedly because the initial symptoms are non-specific, and the sensitivity and specificity of laboratory and radiological methods of analysis are low [5][6][7] . The resulting delay in the commencement of treatment often results in poor prognosis for patients and reduces the chances of survival 7 .…”

Section: Mediastinitis Is a Deep Sternal Wound Infectionmentioning

confidence: 99%

Scintigraphic imaging with technetium-99M-labelled ceftizoxime is a reliable technique for the diagnosis of deep sternal wound infection in rats

et al. 2015

View full text Add to dashboard Cite

PURPOSE:To evaluate whether scintigraphy with technetium-99m-labeled ceftizoxime ( Tc-CFT to infected sternums was greater than to their non-infected counterparts. Mean counts of radioactivity in bacteria-infected sternal regions (SB and SWB) were significantly higher (p = 0.0007) than those of the respective controls (S and SW). CONCLUSION:Scintigraphy with technetium-99m-labeled ceftizoxime is a method that can potentially detect infection post sternotomy and differentiate from aseptic inflammation in animals experimentally inoculated with S. aureus.

show abstract

“…The assessment of sternal healing has been limited by crude methods of clinical assessment rather than a truly objective test-unless there was evidence of sternal dehiscence. Computed tomography (CT) scans are used in the setting of sternal wound complications to assess dehiscence, presence of infection, and the need for sternal reexploration [11,12]. The exquisite bone detail offered by CT makes it the ideal modality for evaluation of bone healing.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Sternal Bone Healing with Computed Tomography and a Quantitative Scoring Algorithm

Stacy¹,

Ahmed²,

Richardson³

et al. 2014

TOMIJ

View full text Add to dashboard Cite

Abstract:Objective: The exquisite bone detail offered by computed tomography makes it the ideal modality for evaluation of bone healing. However, few studies have investigated the normal computed tomographic appearance of the sternum after median sternotomy and, to the best of our knowledge, no computed tomographic classification of sternal healing has been proposed. Given the potential benefit of objective criteria, we propose a validated scoring classification of sternal healing using computed tomography for both clinical and investigational purposes.Methods: Computed tomography scans from 20 patients who underwent a median sternotomy were evaluated for sternal healing at either 3 or 6 months postoperatively. Five anatomic locations along the sternum were selected using defined criteria, and a 6-point quantitative scale was developed to evaluate sternal healing. Independent radiologists read and scored each of the 5 locations on the sternum. Inter-and intra-observer variability was assessed by calculating the kappa statistics to measure the reliability of the scoring algorithm.Results: Calculation of the kappa statistics indicated substantial agreement for intra-observer variability and substantial to almost perfect agreement for inter-observer variability. For intra-observer variability, the kappa statistics ranged from 0.591 to 0.802, and for inter-observer variability, the kappa statistics ranged from 0.590 to 0.969. When the two radiologists differed, the magnitude of the difference was no more than 1 or 2 points. Conclusion:This simple system of evaluating sternal healing had high inter-and intra-observer reliability. Therefore, it may be considered a valid method for assessing sternal osteosynthesis for both clinical and investigative purposes.Ultramini abstract: (49 words): Few studies have investigated the normal computed tomography appearance of the sternum after median sternotomy, and we knew of no computed tomography-based classification of sternal healing. Given the potential benefit of objective criteria, we designed and validated a scoring classification of sternal osteosynthesis for both clinical and investigational purposes.

show abstract

Computed tomography of the sternum and mediastinum after median sternotomy

Cited by 75 publications

References 19 publications

Staphylococcus aureus Bacteremia After Median Sternotomy

Staphylococcus aureus Bacteremia After Median Sternotomy

Scintigraphic imaging with technetium-99M-labelled ceftizoxime is a reliable technique for the diagnosis of deep sternal wound infection in rats

Evaluation of Sternal Bone Healing with Computed Tomography and a Quantitative Scoring Algorithm

Contact Info

Product

Resources

About