Michael C. Brunner, M. D. , R. Scott Mitchell, M. D. , John C

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Presentation transcript:

Prosthetic graft infection: Limitations of indium white blood cell scanning Michael C. Brunner, M.D., R.Scott Mitchell, M.D., John C. Baldwin, M.D., David R. James, M.D., Cornelius Olcott, M.D., John Thomas Mehigan, M.D., I.Ross McDougall, Ph.D., D.Craig Miller, M.D. Journal of Vascular Surgery Volume 3, Issue 1, Pages 42-48 (January 1986) DOI: 10.1067/mva.1986.avs0030042 Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Distribution of prosthetic arterial grafts in 70 patients who underwent evaluation for graft infection with 111In white blood cell scanning. Journal of Vascular Surgery 1986 3, 42-48DOI: (10.1067/mva.1986.avs0030042) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Actuarial survival curves representing life expectancy for patients with true positive 111In white blood cell (WBC) scans (A) in contrast to survival of patients with true negative 111In WBC scans (B). SEM = standard error of mean. Journal of Vascular Surgery 1986 3, 42-48DOI: (10.1067/mva.1986.avs0030042) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Actuarial curve demonstrating probability of freedom from confirmed prosthetic graft infection in patients with true positive 111In white blood cell scans. SEM = standard error of mean. Journal of Vascular Surgery 1986 3, 42-48DOI: (10.1067/mva.1986.avs0030042) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Results of 111In white blood cell scanning in detection of prosthetic infection in 70 patients. Journal of Vascular Surgery 1986 3, 42-48DOI: (10.1067/mva.1986.avs0030042) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 Examples of (A) true positive (anteroposterior projection) and (B) true negative (posteroanterior projection) 111In white blood cell scans. A, White indicates involvement of central limb of graft; involvement of both femoral graft limbs was also present (black arrows). B,Arrow indicates positive 111In uptake in left tuboovarian abscess, but no uptake in aortic graft. Journal of Vascular Surgery 1986 3, 42-48DOI: (10.1067/mva.1986.avs0030042) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 6 Sensitivity, specificity, and overall accuracy of 111In white blood cell scanning in diagnosis of prosthetic graft infection (A) excluding three equivocal scans; (B) considering three equivocal scans as false positive (see text); (C) excluding three equivocal scans and considering four (of eight) false positive scans that detected inflammatory or infectious process in region of graft but no graft infection as true positive. FP = false positive; FN = false negative; N = number of patients. Journal of Vascular Surgery 1986 3, 42-48DOI: (10.1067/mva.1986.avs0030042) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions