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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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2021
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| 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 |
MARC
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| 520 | |a 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. | ||
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