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Turkish Journal of Medical Sciences

DOI

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Abstract

The aim of this study was to evaluate the clinical efficacy of immunoscintigraphy with Tc-99m-labelled antigranulocyte antibody in combination with Tc-99m-methylene-diphosphonate (MDP) bone scanning in diabetic foot infection. The study group comprised 42 Type 2 diabetics with foot infection. Pre- and postprandial blood glucose level, HbA1c, urinary glucose, microalbuminuria, total cholesterol, LDL-cholesterol, HDL-cholesterol, and bacteriological cultures were analyzed. Investigation of transcutaneous oxygen tension, vibration sensation, electromyo-graphy, and Doppler ankle/brachial systolic blood pressure index was carried out. Radiographs centered on the feet were performed. All patients underwent bone scintigraphy with 370 MBq Tc-99m-MDP three hours after injection in 3 projections. Radioimmune planar imunoscintigraphy was performed with 740 MBq Technetium - 99m conjugated with monoclonal antigranulocyte antibody BW 250/183 in the same three projections. Immunoscintigraphy was performed 4 and 24 hours after administration of 740 MBq Tc-99m-MAB BW 250/183 in positive bone scan cases. Final assessment of immunoscintigraphic images based on parallel analysis of isotopic images and final diagnosis revealed 21 true positive cases, 16 true negative cases, 3 false positive cases, and 2 false negative cases. The analysis of diagnostic validity revealed a diagnostic accuracy of 86 %. Immunoscintigraphy with Tc-99m-labelled antigranulocyte antibody in combination with Tc-99m-MDP bone scanning is an efficient method for the early detection of foot bone infection and the precise diagnosis of osteomyelities in diabetics.

Keywords

diabetic foot, infection, immunoscintigraphy, bone scintigraphy

First Page

255

Last Page

259

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