Hybrid SPECT-WBC/MRI in the Diagnosis of Diabetic Foot Syndrome

The goal: to detect the possibilities of the software combined SPECT/ MRI in the detection of osteomyelitis (OM) in patients with diabetic foot syndrome (DFS). Materials and methods. 76 patients with diabetes type I and II, suspected OM (35 (46.0%) men and 41 (54.0%) women, mean age 59.4 ± 7.1 years) were studied. The study included patients with neuropathic (n = 25), ischemic (n = 13) and neuroischemic (n = 38) DFS forms. All patients underwent scintigraphy with labeled leukocytes, 30 patients underwent magnetic resonance imaging (MRI). The combination produced by using software RView 9.06 (Colin Studholme). Results. By using labeled leukocyte scintigraphy for the diagnosis of oM were obtained 25 TP, 38 TN, 12 FP and 1 FN results. The accuracy was 82.9%. FP results were due to the low resolution of the method and the small size of the object. One FN result was caused by reduced blood flow in a patient with ischemic form of the DFS. By using MRI obtained 20 TP, 16 TN, 4 FP and 2 FN results. The diagnostic accuracy of the method was 85.7%. The FP results were due to the complexity of the differential diagnosis of bone marrow edema and inflammatory infiltration. In assessing the 42 hybrid SPECT/MRI images of 21 TP, 17 TN, 3 FP, 1 FN result have been identified. Diagnostic accuracy was 95.9%. Conclusion. The study shows a higher diagnostic SPECT/MRI performance in detecting OM in patients with DFS (sensitivity and specificity were 95.5% and 85.0% respectively) compared with the isolated using of MRI and scintigraphy.

синдром диабетической стопы, остеомиелит, магнитно-резонансная томография, однофотонная эмиссионная компьютерная томография, гибридные изображения, diabetic foot syndrome, osteomyelitis, magnetic resonance imaging, single photon emission computed tomography, hybrid images

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