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Potential utility of bone scan in cranial bone flap osteomyelitis

Annals of Nuclear Medicine volume 33, pages 424–433 (2019)Cite this article

Abstract

Objective

Currently, the diagnosis of bone flap osteomyelitis (BFO) remains a challenge for medical imaging. The present study aimed to identify predictive scintigraphic patterns of BFO.

Methods

This retrospective study reviewed planar bone scan of patients with suspected BFO between 2010, and 2016. A total of 15 patients were included. Final diagnosis of BFO was obtained by histological and bacteriological documentation. Eight scintigraphic signs potentially helpful were reviewed and correlated with the final diagnosis individually or in combination through Fischer exact test.

Results

Eight patients out of 15 (53.3%) were diagnosed with BFO. Radionuclide uptake inside the bone flap during blood-pool phase was predictive for BFO (p = 0.007) with 75.0% sensitivity 100% specificity, and 86.7% accuracy. In combination, radionuclide uptake inside the bone flap or a spreading wavefront between blood-pool and delayed phases was associated with BFO (p = 0.007). It did not improve diagnostic performance.

Conclusion

Using well-defined and reproducible scintigraphic signs, bone scan is helpful for the diagnosis of BFO.

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Funding

This study did not receive any funding.

Author information

Affiliations

  1. Department of Neuroradiology, East Group Hospital, Hospices Civils de Lyon, 59 Bvd Pinel, 69634, Lyon Cedex, France

    Alexandre Bani Sadr

  2. Department of Nuclear Medicine, East Group Hospital, Hospices Civils de Lyon, 59 Bvd Pinel, 69634, Lyon Cedex, France

    Alexandre Bani Sadr, Jeremie Tordo & Marc Janier

  3. Imagerie nucléaire de l’Ouest Lyonnais et de l’Ain, 25 Av des Sources, 69009, Lyon, France

    Bastien Gregoire

  4. Department of Neurosurgery, East Group Hospital, Hospices Civils de Lyon, 59 Bvd Pinel, 69634, Lyon Cedex, France

    Jacques Guyotat

  5. Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France

    Andre Boibieux & Marc Janier

  6. Université Claude Bernard Lyon 1, 43 Bvd du 11 Novembre 1918, 69100, Villeurbanne, France

    Jacques Guyotat

  7. Department of Neuroradiology, East Group Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69500, Bron, France

    Alexandre Bani Sadr

Authors
  1. Alexandre Bani Sadr
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  2. Bastien Gregoire
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  3. Jeremie Tordo
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  4. Jacques Guyotat
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  5. Andre Boibieux
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  6. Marc Janier
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Correspondence to Alexandre Bani Sadr.

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Bani Sadr, A., Gregoire, B., Tordo, J. et al. Potential utility of bone scan in cranial bone flap osteomyelitis. Ann Nucl Med 33, 424–433 (2019). https://doi.org/10.1007/s12149-019-01351-y

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  • DOI: https://doi.org/10.1007/s12149-019-01351-y

Keywords

  • Craniotomy
  • Osteomyelitis
  • Postoperative complications
  • Bone scan
  • Infection