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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Usefulness of 18F-FDG PET/CT in a case of suspected vascular graft infection
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Vol. 36. Issue 3.
Pages 185-188 (May - June 2017)
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Vol. 36. Issue 3.
Pages 185-188 (May - June 2017)
Clinical note
Usefulness of 18F-FDG PET/CT in a case of suspected vascular graft infection
Utilidad de la 18F-FDG PET/TC en un caso de sospecha de infección de injerto vascular
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R. Fernández-Lópeza,
Corresponding author
rosafernandezlopez@hotmail.com

Corresponding author.
, A. de-Bonilla-Damiáa, I. Acevedo-Báñeza, R. Luque-Márquezb, I. Borrego-Doradoa
a UDIM, Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, Spain
b Servicio de Medicina Interna-Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Abstract

Vascular prosthetic graft infection (VPGI) is associated with high mortality and morbidity. An early and accurate diagnosis is essential in order to give the most appropriate treatment. The case is presented of a 74 year old male subjected to an aortobifemoral bypass graft, with clinical suspicion of VPGI with inconclusive tests. Later on an 18F-FDG PET/CT study showed a pathological uptake, suggestive of periprosthetic infection, as well as an incidental pulmonary lesion, suggestive of a primary neoplasm. A new 18F-FDG PET/CT showed a significant improvement in the uptake by the vascular graft after prolonged antibiotic treatment. 18F-FDG is a promising tracer for detecting VPGI as the accumulated activated white cells at the infection site have a high demand for 18F-FDG, and could help define the response to antibiotic treatment.

Keywords:
PET/CT
18F-FDG
Infection
Vascular graft
Vascular prosthetic graft infection
Resumen

La infección del injerto vascular protésico (VPGI) se asocia a una gran morbimortalidad. Es esencial un diagnóstico precoz y preciso para llevar a cabo el tratamiento más adecuado. Presentamos el caso de un varón de 74 años intervenido de by-pass aorto-bifemoral con sospecha clínica de infección de la prótesis vascular y pruebas complementarias no concluyentes, en el que se realiza un estudio PET/TC con 18F-FDG que muestra una captación patológica a nivel periprotésico sugestiva de infección, así como lesión incidental pulmonar sugestiva de neoplasia primaria. Una 18F-FDG PET/TC de control tras tratamiento antibiótico prolongado demostró una mejoría significativa en la captación en el injerto vascular. La 18F-FDG es un trazador prometedor para detectar VPGI, ya que los leucocitos activados tienen una gran demanda de la 18F-FDG y se acumulan en el lugar de la infección, y podría ayudar a definir la respuesta al tratamiento antibiótico.

Palabras clave:
PET/TC
18F-FDG
Infección
Injerto vascular
Infección del injerto vascular protésico

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