title: Usefulness of 18F-fluorodeoxyglucose positron emission tomography scan in the assessment of periprosthetic collections: report of 2 cases with opposite management.
abstract: Vascular prosthetic infection is a rare but serious complication of vascular surgery that requires rapid diagnosis and treatment. It is associated with high rates of amputation and death. The diagnosis is difficult when faced with a chronic nonspecific clinical presentation. We report 2 cases showing the diagnostic usefulness of positron emission tomography (PET). In 1 case, PET excluded with certainty the septic character of a periprosthetic collection fistulized with the skin by showing a periprosthetic fixation insufficient to diagnose an infection. In the other case, it confirmed the prosthetic infection in association with an evocative clinical picture by revealing a pathologic periprosthetic hyperfixation. PET scan therefore drew aside the diagnosis of prosthetic infection faced with a mild clinical and paraclinical presentation in the first case, and made it possible to pose it with certainty in the second case. This examination made it possible to save valuable time in 1 case and to elucidate the periprosthetic collection in the other case. Therefore, the rule of surgical explantation of any prosthesis with flow or periprosthetic collection is no more univocal.
authors.affiliation: Department of Vascular Surgery, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France. Electronic address: camchouf@hotmail.com.
authors.forename: Camille
authors.initials: C
authors.lastname: Choufani
authors.affiliation: Department of Vascular Surgery, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Pierret
authors.affiliation: Department of Nuclear Medicine, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Gontier
authors.affiliation: Department of Vascular Surgery, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Mlynski
authors.affiliation: Department of Vascular Surgery, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: de Kerangal
authors.affiliation: Department of Vascular Surgery, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Chapuis
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D020878:Device Removal; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000601:surgery; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18