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Diagnosis of Prosthetic Vascular Graft Infection by Technetium-99m-HMPAO-Labeled Leukocytes

Department of Nuclear Medicine, University Hospital, Zaragoza, Spain

Correspondence: For correspondence or reprints contact: Enrique Prats, MD, Department of Nuclear Medicine, University Hospital, Av. San Juan Bosco No. 15, 50009 Zaragoza, Spain.

ABSTRACT

The purpose of this study was to determine the usefulness of ^99mTc-HMPAO-labeled leukocyte scans in the diagnosis of prosthetic vascular graft infection. Methods: We performed 75 scans in 61 patients with vascular grafts. Thirty-six patients were evaluated for suspected infection and 25 were control patients. Scintigraphic images were performed at 5 min, 30 min, 3 hr and, occasionally, 24 hr. Persistent increased uptake at 3 hr along the suspected area of the graft was considered evidence of graft infection. Results: All 20 infected grafts were detected with ^99mTc-HMPAO leukocyte scan. The sensitivity and specificity of the scan in the detection of infected graft were 100%. We also detected two pelvic abscesses, two infected fistulae, two soft-tissue infections, three cases of ischemic colitis, one acute diverticulitis, one infected hematoma, one septic arthritis and one noninfected hematoma. One patient with a superficial groin infection had a negative scan. The eight pseudoaneurysms did not show scintigraphic evidence of graft infection. Correlative CT studies were performed in 12 cases. Conclusion: Technetium-99m-HMPAO-labeled leukocyte scan is an accurate and valuable diagnostic method for evaluation of suspected prosthetic vascular graft infection.

Key Words: vascular graft infection • technetium-99m-HMPAO leukocyte scan

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