Objective To investigate the application of positron emission tomography/computed tomography (PET/CT) in qualitative and localization diagnosis of deep occult infection of mediastinum after cardiac great vessel replacement.Methods The patients (n=6) with suspected deep occult infection of mediastinum after thoracic aorta replacement through median sternal incision were chosen from the Department of Cardio-Thoracic Surgery of Beijing Royal Integrative Medicine Hospital from Jan. 2013 to May 2017, and they were given 18F-fluorodexygl-gucose (FDG)-PET/CT examination. The infection scope and positions of artificial cardiac great vessels were decided according to PET/CT images. The operation methods and incision selection were guided by PET/CT images for debridement, drainage and muscle flap prothesis.Results Surgical exploration showed that all 6 patients had deep occult infection of mediastinum after cardiac great vessel replacement, and among them, 5 with infection spread round artificial vessels, 1 with infection involved vessel wall, and 2 complicated by sterna infection. PET/CT was accuracy in the diagnosis of deep occult infection of mediastinum after cardiac great vessel replacement in 6 patients.Conclusion PET/CT is accuracy in the qualitative and localization diagnosis of deep occult infection of mediastinum and infection round artificial vessels after cardiac great vessel replacement, which can be taken for guiding surgical debridement.%目的 探讨正电子发射计算机断层显像(PET/CT)在心脏大血管置换术后深部隐匿性纵隔感染的定性、定位诊断.方法 选择2013年1月～2017年5月对北京王府中西医结合医院胸心外科6例胸骨正中切口胸主动脉置换术后怀疑深部隐匿性感染的患者进行PET/CT检查.根据PET/CT的影像对6例患者的人工大血管感染范围及位置进行判断,引导手术方法与切口的选择进行清创引流,肌瓣修复.结果手术探查6例心脏大血管置换术后患者,均存在深部纵隔感染,其中5例感染蔓延到人工血管周围,另一例累及血管壁,2例合并胸骨感染;本研究中6例患者PET/CT对心脏大血管置换术后深部隐匿性纵隔感染诊断准确.结论 PET/CT对心脏大血管置换术后深部纵隔和人工血管周围隐匿性感染的定位及定性诊断准确,可用于引导手术清创.
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