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Tesi di specializzazione (5 anni)
Multimodal imaging in cardiovascular infections: the case of the infectious complications after Bentall procedure
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Course of study
relatore Prof.ssa Erba, Paola Anna
Graduation session start date
Cardiovascular infections represent a group of heterogeneous conditions involving the heart and the vessels, extending to prosthetic material in case of the implantation of devices. Despite their relative low incidence, these conditions that are associated with high morbidity and mortality. After Bentall procedure, the diagnosis of infectious complications is challenging, being possible the diagnosis of valve endocarditis and/or vascular graft infection isolated or associated with mediastinitis and sternum osteomyelitis. In this work between May 2005 and December 2015, out of a total of 623 patients referred for nuclear medicine procedures for suspected infection of the cardiovascular system, we selected 47 patients (13 women and 34 men, mean age 62.213.7 years, median 66 years, range 29-83 years) with suspected infection after replacement of the aortic valve and ascending aorta according to the Bentall procedure (mean time from the surgery 41.9 months, range 1 month-17 years). A total of 67 imaging procedures were performed: 99mTc-WBC scan (33 patients, 41 scans, 34 baseline scan and 7 for antimicrobial treatment assessment) and/or [18F]FDG-PET/CT (20 patients, 26 scans, 22 baseline scan and 4 for antimicrobial treatment assessment), 6 patients performed both procedures 2 days apart. In this population the use of molecular imaging techniques result in a overall diagnostic accuracy of XXX (sensitivity XXX, specificity XXX, PPV XXX and NPV XXX), higher for XXX (sensitivity XXX, specificity XXX, PPV XXX and NPV XXX, accuracy XXX) and compared to XXX (sensitivity XXX, specificity XXX, PPV XXX and NPV XXX, accuracy XXX).