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The AMANDUS Project: advanced microperfusion assessed non-union diagnostics with contrast-enhanced ultrasound(CEUS) for the detection of infected lower extremity non-unions

The pre-operative determination of infection plays a decisive role in non-union treatment. This study investigated in a large cohort the diagnostic potential of contrast-enhanced ultrasound (CEUS) as stand-alone method for the differentiation between aseptic and infected non-unions. Of 109 patients...

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Main Authors: Doll, Julian (Author) , Groß, Sascha (Author) , Weber, Marc-André (Author) , Schmidmaier, Gerhard (Author) , Fischer, Christian (Author)
Format: Article (Journal)
Language:English
Published: 8 May 2019
In: Ultrasound in medicine & biology
Year: 2019, Volume: 45, Issue: 9, Pages: 2281-2288
ISSN:1879-291X
DOI:10.1016/j.ultrasmedbio.2019.05.007
Online Access:Verlag, Volltext: https://doi.org/10.1016/j.ultrasmedbio.2019.05.007
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0301562919302157
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Author Notes:Julian Doll, Sascha Gross, Marc-André Weber, Gerhard Schmidmaier, Christian Fischer
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Summary:The pre-operative determination of infection plays a decisive role in non-union treatment. This study investigated in a large cohort the diagnostic potential of contrast-enhanced ultrasound (CEUS) as stand-alone method for the differentiation between aseptic and infected non-unions. Of 109 patients with lower extremity non-unions (tibia n=78, femur n=31) osseous perfusion with CEUS was prospectively assessed before revision surgery. The perfusion was quantified via time-intensity curves and peak enhancement (PE) (arbitrary unit [au]). Significant perfusion differences between aseptic and infected non-unions were evident (PE, p < 0.001). The sensitivity and specificity for the detection of infected tibial and femoral non-unions could be determined with 85.1% and 88.7% (cutoff PE: 81.2 au). CEUS illustrates tibial and femoral non-union perfusion in real time and discriminates reliably between aseptic and infected non-unions. Consequently, when CEUS is integrated into the diagnostic routine algorithm, non-union revision surgery can be planned more accurately as a single or multistep procedure.
Item Description:8 May 2019
Gesehen am 05.02.2020
Physical Description:Online Resource
ISSN:1879-291X
DOI:10.1016/j.ultrasmedbio.2019.05.007

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