Contrast-Enhanced Ultrasound Quantifies the Perfusion Within Tibial Non-Unions and Predicts the Outcome of Revision Surgery

Ultrasound in Medicine & Biology
Daniel KrammerChristian Fischer

Abstract

Vascularity is one of the factors determining successful bone regeneration. This prospective study focused on quantifying the microperfusion of tibial non-unions with contrast-enhanced ultrasound (CEUS) 12 wk after revision surgery and comparing it with the osseous consolidation at a maximum of 24 mo assessed with standard radiography and computed tomography. Of 36 patients with tibial non-unions, 28 (77.8%) manifested consolidation, and 8 patients required further revision surgery. CEUS revealed significantly higher perfusion in consolidated versus persistent non-unions for all quantification parameters (e.g., wash-in perfusion index p = 0.036). Receiver operating characteristic analysis revealed a sensitivity of 82.1% and specificity of 75.0% with a wash-in perfusion index cutoff at 19.9 a.u. for diagnosing persisting non-unions. More than 1 y ahead of the final radiologic diagnostic examination, CEUS could predict eventual consolidation based on the osseous perfusion as soon as 12 wk postoperatively. This information can be crucial for the decision-making process for re-revision at an early stage.

Citations

Apr 5, 2019·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Lin JinXiao-Hua Yao
May 18, 2020·Der Radiologe·Christian Fischer
Apr 29, 2020·Therapeutics and Clinical Risk Management·Christian FischerJulian Doll
Apr 23, 2020·Current Osteoporosis Reports·G Bradley ReahlMichael Kain
Aug 14, 2020·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Christian FischerJulian Doll
Aug 19, 2020·Der Unfallchirurg·Christian Fischer
Jan 28, 2021·Animals : an Open Access Journal From MDPI·Francesco MacrìSimona Di Pietro

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