Ultraschall Med 2018; 39(S 01): S29
DOI: 10.1055/s-0038-1670438
Wissenschaftliche Vortragssitzungen
Wi-Vo 07 Kontrastmittel: Fr. 16.11. 08:30 – 10:00 Shanghai 2
Georg Thieme Verlag KG Stuttgart · New York

Contrast-enhanced ultrasound (CEUS) quantifies the perfusion within tibial non-unions and predicts the outcome of revision surgery

D Krammer
1   Center for Orthopedics, Trauma Surgery and Spinal Cord Injury
,
G Schmidmaier
1   Center for Orthopedics, Trauma Surgery and Spinal Cord Injury
,
MA Weber
2   Institute of Diagnostic and Interventional Radiology University Medical Center Rostock
3   Diagnostic and Interventional Radiology/1,3 Heidelberg University Hospital
,
J Doll
1   Center for Orthopedics, Trauma Surgery and Spinal Cord Injury
,
C Rehnitz
3   Diagnostic and Interventional Radiology/1,3 Heidelberg University Hospital
,
C Fischer
1   Center for Orthopedics, Trauma Surgery and Spinal Cord Injury
› Author Affiliations
Further Information

Publication History

Publication Date:
24 October 2018 (online)

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    Introduction:

    Vascularity is one of the determining factors of successful bone regeneration. This prospective study focused on quantifying the microperfusion of tibial non-unions with contrast-enhanced ultrasound (CEUS) and comparing it to the outcome.

    Materials and Methods:

    36 patients with tibial fracture non-unions received a CEUS examination 12 weeks after revision surgery and the osseous microperfusion was quantified. The osseous consolidation at a maximum of 24 months was assessed with standard x-rays and computed tomography.

    Results:

    28 out of 36 non-unions (77.8%) showed consolidation, while 8 patients required further revision surgery. CEUS demonstrated significantly higher perfusion in consolidated vs. persistent non-unions for all quantification parameters (e.g.: Wash-in Perfusion Index (WiPI) p = 0.036). The Receiver Operating Characteristics (ROC) analysis revealed a sensitivity/specificity of 82.1%/75.0% with a WiPI cut-off at 19.9 a.u. for diagnosing persisting non-unions.

    Discussion:

    More than one year ahead of the final radiologic diagnostic examination, CEUS could predict eventual consolidation based on the osseous perfusion as soon as 12 weeks postoperatively. This information can be crucial for the decision making process of re-revision at an early stage.


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