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OBJECTIVE: To evaluate the diagnostic performance of 18F-FDG PET/CT in the detection of stent graft infection (SGI). METHODS: In a retrospective study, two nuclear medicine physicians have independently analyzed 17 18F-FDG PET/CT examinations performed for clinical suspicion of SGI. The images were evaluated for the uptake pattern and intensity, and by the maximum standard uptake value (SUVmax), the target-to-background ratio with blood pool (TBRBP) and liver uptake (TBRhep) as a reference. The SGI was defined as the presence of focal hyperactivity with an intensity exceeding hepatic uptake. CT images were independently assessed for signs of SGI. Clinical review of all further patients' data served as the standard of reference. RESULTS: Nine cases were established as SGI by the clinical review. PET/CT correctly diagnosed SGI in eight and yielded a sensitivity of 89% and specificity of 100%. The mean SUVmax, TBRBP, and TBRhep values were 9.8 ± 4.0, 6.9 ± 2.6, and 4.6 ± 1.7 in the group of patients with true SGI, and 4.0 ± 1.1, 2.5 ± 0.4 (p < 0.001) and 1.9 ± 0.2 (p < 0.001) in true negative cases, respectively. CT alone showed a sensitivity of 78% and specificity of 100% and was concordant with PET/CT in 14 cases. The best performing threshold values of SUVmax, TBRBP, and TBRhep were 5.6, 3.5, and 2.2, respectively. CONCLUSION: 18F-FDG PET/CT with expert evaluation, semiquantitative and quantitative image analysis with the proposed threshold values for SUVmax, TBRBP, and TBRhep has good diagnostic accuracy in the detection of SGI. We propose that visual grading scale for SGI should use hepatic uptake as a visual reference.

MeSH
aorta chirurgie MeSH
fluorodeoxyglukosa F18 * MeSH
infekce spojené s protézou diagnostické zobrazování etiologie MeSH
lidé MeSH
PET/CT * MeSH
počítačové zpracování obrazu MeSH
retrospektivní studie MeSH
senioři MeSH
senzitivita a specificita MeSH
stenty škodlivé účinky mikrobiologie MeSH
výkony cévní chirurgie škodlivé účinky MeSH
Check Tag
lidé MeSH
mužské pohlaví MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH

Článek

Endofibróza pánevní tepny
[Ilac artery endofibrosis]

Postgraduální medicína. 2019 ; 21 (1) : 14-20.

Postgraduální med.
ISSN 1212-4184
Medvik
Zdroj

MeSH
arteria iliaca * chirurgie patologie MeSH
diagnostické zobrazování metody trendy MeSH
dospělí MeSH
endovaskulární výkony metody trendy MeSH
fibróza * diagnóza etiologie chirurgie MeSH
klinický obraz nemoci MeSH
lidé MeSH
nemoci cév diagnóza komplikace terapie MeSH
sportovní úrazy * prevence a kontrola terapie MeSH
výkony cévní chirurgie metody trendy MeSH
Check Tag
dospělí MeSH
lidé MeSH
mužské pohlaví MeSH
Publikační typ
kazuistiky MeSH
přehledy MeSH

Abstrakt

The value of FDG PET/CT in the diagnosis of stent graft infections

Kazuistiky v angiologii. 2018 ; 5 (1) : 67-68. (4th Congress of the European Society for Vascular Medicine. Prague, Czech Republic, March 18-20. 43rd Czech Angiology Days 2018. Prague, Czech Republic, March 18-20)

ISSN 2336-2790
ISBN 978-80-87969-36-6
Medvik
Zdroj

Angiological Days ... with international participation. 2018 ; () : 67-68.

ISSN 2336-2790
Medvik
Zdroj

Publikační typ
abstrakt z konference MeSH

Kapitola

Žilní onemocnění

Kardiologie. 2017 ; () : 1026-1050.

ISBN 978-80-204-4434-9
Medvik
Zdroj

Článek

Vzácná příčina akutní končetinové ischemie obou horních i dolních končetin způsobená prolongovaným vazospasmem
[Rare cause of acute limb ischemia of both upper and lower limbs caused by prolonged vasospasm]

Cor et Vasa (Brno). 2017 ; 59 (5) : 577-580. [epub] e503-e50

ISSN 0010-8650
Medvik
Zdroj

Akutní končetinová ischemie je život ohrožující stav způsobený různorodými příčinami zahrnujícími trombózu nasedající na aterosklerotický plát a periferní embolizaci. U mladých jedinců je nicméně nutné zvažovat i jinou etiologii obtíží. Popisujeme vzácný případ 19letého muže s akutní končetinovou ischemií obou horních a dolních končetin zapříčiněnou prolongovaným vazospasmem.

Acute limb ischemia is a life-threatening condition caused by various etiologies including atherothrombosis and peripheral embolization. However, in young adults other etiologies should also be considered. We report a rare case of a 19-year-old man developing acute limb ischemia of both upper and lower limbs due to prolonged vasospasm.

MeSH
CT angiografie metody MeSH
koronární vazospasmus MeSH
lidé MeSH
mladý dospělý MeSH
onemocnění periferních arterií * diagnóza etiologie terapie MeSH
výsledek terapie MeSH
Check Tag
lidé MeSH
mladý dospělý MeSH
mužské pohlaví MeSH
Publikační typ
kazuistiky MeSH

Článek

Percutaneous Mechanical Thrombectomy Using Rotarex® S Device in Acute Limb Ischemia in Infrainguinal Occlusions

BioMed research international. 2017 ; 2017 (-) : 2362769. [pub] 20170507

Biomed Res Int
ISSN 2314-6141
Medvik
Zdroj

PURPOSE: To evaluate the effectiveness of percutaneous mechanical thrombectomy using Rotarex S in the treatment of acute limb ischemia (ALI) in infrainguinal occlusions in a retrospective study of patients treated in our institution. METHODS: In this study, we identified a total of 147 ALI patients that underwent mechanical thrombectomy using Rotarex S at our institution. In 82% of the cases, percutaneous thrombectomy was used as first-line treatment, and for the remainder of the cases, it was used as bailout after ineffective aspiration or thrombolysis. Additional fibrinolysis and adjunctive aspirational thrombectomy were utilized for outflow occlusion when required. Procedural outcomes, amputation rate, and mortality at 30 days were evaluated. RESULTS: Of the 147 patients treated with mechanical thrombectomy, Rotarex S was used as first-line treatment in 120 cases and as second-line treatment in 27 cases. Overall, we achieved 90.5% procedural revascularization success rate when combining mechanical thrombectomy with limited thrombolysis for severe outflow obstruction, and 1 death and 3 amputations were observed. We achieved primary success in 68.7% of the patients with the mechanical thrombectomy only, and in 21.8% of the patients, we successfully used additional limited thrombolysis in the outflow. The overall mortality was 0.7% and amputation rate was 2% at 30 days. CONCLUSION: Percutaneous mechanical thrombectomy as first-line mini-invasive treatment in infrainguinal ALI is safe, quick, and effective, and the performance outcomes can be superior to that of traditional surgical embolectomy.