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The AMANDUS project part II: advanced microperfusion assessed non-union diagnostics with Contrast-Enhanced Ultrasound (CEUS) : a reliable diagnostic tool for the management and pre-operative detection of infected upper-limb non-unions

The management of upper-limb non-unions can be challenging, especially when infection is existent. Thus, pre-operative detection of infection plays a relevant role in non-union treatment. This study investigated in a large cohort the diagnostic potential of contrast-enhanced ultrasound (CEUS) as sta...

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Bibliographic Details
Main Authors: Doll, Julian (Author) , Streblow, Jan (Author) , Weber, Marc-André (Author) , Schmidmaier, Gerhard (Author) , Fischer, Christian (Author)
Format: Article (Journal)
Language:English
Published: 2021
In: Ultrasound in medicine & biology
Year: 2021, Volume: 47, Issue: 3, Pages: 478-487
ISSN:1879-291X
DOI:10.1016/j.ultrasmedbio.2020.11.028
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ultrasmedbio.2020.11.028
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0301562920305366
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Author Notes:Julian Doll, Jan Streblow, Marc-André Weber, Gerhard Schmidmaier, and Christian Fischer
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Summary:The management of upper-limb non-unions can be challenging, especially when infection is existent. Thus, pre-operative detection of infection plays a relevant 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 differentiating between aseptic and infected upper-limb non-unions. Osseous perfusion of 50 upper-extremity non-unions (radius/ulna, n=20; humerus, n=22; clavicle, n=8) was prospectively assessed with CEUS before revision surgery. The perfusion was quantified via time-intensity curves and peak enhancement (in arbitrary units). Significant perfusion differences between aseptic and infected non-unions could be detected (peak enhancement, p < 0.001). The sensitivity and specificity for the detection of infected upper-limb non-unions were 80% and 94.3% (cutoff peak enhancement: 130.8 arbitrary units). CEUS reliably differentiates between aseptic and infected upper-limb non-unions. Consequently, CEUS should be integrated into the daily diagnostic routine algorithm to plan non-union revision surgery more precisely as a single- or multi-step procedure.
Item Description:Online verfügbar: 17. Dezember 2020
Gesehen am 30.03.2021
Physical Description:Online Resource
ISSN:1879-291X
DOI:10.1016/j.ultrasmedbio.2020.11.028

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