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García-Gómez, G. Sabatel-Hernández" "autores" => array:3 [ 0 => array:4 [ "nombre" => "P.A." "apellidos" => "de la Riva-Pérez" "email" => array:1 [ 0 => "pabloadelariva@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "F.J." "apellidos" => "García-Gómez" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Sabatel-Hernández" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Gestión Clínica de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Orientación diagnóstica de infección de prótesis aorto abdominal mediante <span class="elsevierStyleSup">18</span>F-FDG PET/TC" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 914 "Ancho" => 1071 "Tamanyo" => 139159 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">This case concerns a 75-year-old male patient with a history of arterial hypertension, chronic renal failure in hemodialysis and carrier of a prosthesis due to an abdominal aortic aneurysm. Six years after the implantation, the patient presented episodes of gastrointestinal hemorrhage associated with prosthetic-duodenal fistula.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We requested 2-deoxy-2-[fluorine-18]fluoro-<span class="elsevierStyleSmallCaps">d</span>-glucose positron emission tomography/computed tomography (<span class="elsevierStyleSup">18</span>F-FDG PET/CT) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) to rule out prosthetic infection. The results showed increased periprosthetic uptake in the abdominal aortic portion located between L2 and L3 (arrows). The trajectory measured approximately 4<span class="elsevierStyleHsp" style=""></span>cm and presented a maximum standardized uptake value (SUV<span class="elsevierStyleInf">max</span>) of 6.7 in the anterior wall, which had thickened (SUV for a normal aorta, 2.6), which was probably related to the infectious/inflammatory process in this area.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Posterior CT angiography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B) showed an aortic aneurysm measuring 4<span class="elsevierStyleHsp" style=""></span>cm in diameter, with a penetrating subrenal ulcer measuring 7.7<span class="elsevierStyleHsp" style=""></span>mm in height and 5.5<span class="elsevierStyleHsp" style=""></span>mm deep (arrows), as well as an aneurysm encompassing both iliac territories.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The decision was made to perform a left axillobifemoral bypass. During the immediate postoperative period, the patient presented episodes of hematemesis and syncope. Emergency surgery was performed with removal of the prosthetic and sectioning of the aortoduodenal fistula.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Pathology revealed a tubular segment of prosthetic material measuring 9<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>cm, which presented coagulated hematologic material in its interior and attached fibrinoid residue in which ampicillin-sensitive <span class="elsevierStyleItalic">Enterococcus avium</span> was isolated.</p><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET/CT has therefore been shown to be a sensitive and useful technique for diagnosing infectious processes in vascular prostheses.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-08-20" "fechaAceptado" => "2018-09-07" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: de la Riva-Pérez PA, García-Gómez FJ, Sabatel-Hernández G. Orientación diagnóstica de infección de prótesis aorto abdominal mediante <span class="elsevierStyleSup">18</span>F-FDG PET/TC. Rev Clin Esp. 2020;220:71–72.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 914 "Ancho" => 1071 "Tamanyo" => 139159 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022000000001/v1_202002130124/S2254887418301954/v1_202002130124/en/main.assets" "Apartado" => array:4 [ "identificador" => "71811" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Medicine in images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022000000001/v1_202002130124/S2254887418301954/v1_202002130124/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418301954?idApp=WRCEE" ]
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Medicine in Images
Diagnostic orientation of abdominal aortic graft infection using 18F-FDG PET/CT
Orientación diagnóstica de infección de prótesis aorto abdominal mediante 18F-FDG PET/TC
P.A. de la Riva-Pérez
, F.J. García-Gómez, G. Sabatel-Hernández
Corresponding author
Unidad de Gestión Clínica de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, Spain