{"id":24577,"date":"2025-07-21T10:21:23","date_gmt":"2025-07-21T08:21:23","guid":{"rendered":"https:\/\/www.bmscience.net\/blog\/?p=24577"},"modified":"2025-07-27T10:11:10","modified_gmt":"2025-07-27T08:11:10","slug":"scintigrafia-con-leucociti-autologhi-marcati-con-99mtc-hmpao","status":"publish","type":"post","link":"https:\/\/bmscience.net\/blog\/scintigrafia-con-leucociti-autologhi-marcati-con-99mtc-hmpao\/","title":{"rendered":"Scintigrafia con leucociti autologhi marcati con 99mTc-HMPAO"},"content":{"rendered":"\n<p>La marcatura dei leucociti autologhi con <strong><sup>99m<\/sup>Tc-HMPAO<\/strong> \u00e8 attualmente la metodica pi\u00f9 utilizzata nella medicina nucleare per la diagnosi di infezioni grazie a diversi vantaggi rispetto alla tradizionale marcatura con <strong><sup>111<\/sup>In-oxina<\/strong>:<\/p>\n\n\n<div id=\"bmscience2774195941\" style=\"margin-top: 15px;margin-left: 15px;float: right;\"><a href=\"https:\/\/amzn.to\/40yDUd0\" target=\"_blank\" aria-label=\"B1UNwQRyIDL (1)\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/B1UNwQRyIDL-1.gif\" alt=\"\"  width=\"300\" height=\"169\"   \/><\/a><\/div>\n\n\n<ul class=\"wp-block-list\">\n<li><strong>migliori caratteristiche fisiche<\/strong> per la gamma-camera (140 keV e miglior risoluzione spaziale con una migliore qualit\u00e0 delle immagini);<\/li>\n\n\n\n<li><strong>maggiore disponibilit\u00e0<\/strong> e <strong>costo pi\u00f9 contenuto<\/strong>;<\/li>\n\n\n\n<li><strong>minore dose assorbita<\/strong> dal paziente;<\/li>\n\n\n\n<li><strong>rileva le anomalie in poche ore <\/strong>dall&#8217;iniezione (2-4 h).<\/li>\n<\/ul>\n\n\n\n<p>Tuttavia, <strong><sup>111<\/sup>In-oxina<\/strong> resta preferibile in alcuni casi (es. malattia infiammatoria intestinale e infezioni renali), dove la minor attivit\u00e0 fisiologica nel tratto gastrointestinale e urinario \u00e8 vantaggiosa per la lettura.<\/p>\n\n\n\n<p>Si possono impiegare <strong>granulociti isolati<\/strong> o <strong>leucociti misti<\/strong>. In quest\u2019ultimo caso, circa il <strong>70\u201380% dell\u2019attivit\u00e0 radioattiva<\/strong> si lega comunque ai granulociti neutrofili, che sono le cellule primariamente coinvolte nei processi infettivi acuti.<\/p>\n\n\n\n<div class=\"wp-block-advgb-summary alignnone\"><div class=\"advgb-toc-header collapsed\">INDICE<\/div><ul class=\"advgb-toc alignnone\" style=\"display:none\"><li class=\"toc-level-1\"><a href=\"#principali-indicazioni-cliniche-9030f37e-9168-40d0-a80e-4527412f25e5\" style=\"color:#1a202c\">Principali indicazioni cliniche<\/a><\/li><li class=\"toc-level-1\"><a href=\"#radiofarmaco-99mtchmpao-46feac09-a7c1-41a4-89e4-255f5feb3e98\" style=\"color:#1a202c\">Radiofarmaco: 99mTc-HMPAO<\/a><\/li><li class=\"toc-level-1\"><a href=\"#precauzioni-operative-15e905f2-3f44-49d8-b71b-4d705d889c5b\" style=\"color:#1a202c\">Precauzioni operative<\/a><\/li><li class=\"toc-level-1\"><a href=\"#controllo-di-qualita-della-preparazione-a106f682-004f-4fe3-8a82-bf615acfc365\" style=\"color:#1a202c\">Controllo di qualit\u00e0 della preparazione<\/a><\/li><li class=\"toc-level-1\"><a href=\"#procedura-di-radiomarcatura-0463ebf4-84ca-4ed4-97e6-7f09a39d99b9\" style=\"color:#1a202c\">Procedura di radiomarcatura<\/a><\/li><li class=\"toc-level-1\"><a href=\"#acquisizione-2bcce220-0002-43f8-8cc6-15581b5a0a6e\" style=\"color:#1a202c\">Acquisizione<\/a><\/li><li class=\"toc-level-1\"><a href=\"#analisi-delle-immagini-733d2d92-1d62-467e-ba31-72c96ed9ed46\" style=\"color:#1a202c\">Analisi delle immagini<\/a><\/li><li class=\"toc-level-1\"><a href=\"#limiti-e-svantaggi-b95a7e18-16df-45f4-a914-5ebf14c7674d\" style=\"color:#1a202c\">Limiti e svantaggi<\/a><\/li><li class=\"toc-level-1\"><a href=\"#risultati-e-osservazioni-526ee50e-7c4a-4ffa-bd4b-d68346fb41b1\" style=\"color:#1a202c\">Risultati e osservazioni<\/a><\/li><li class=\"toc-level-1\"><a href=\"#casi-clinici-aa8a32dd-79aa-4645-96c7-4f5330c410fd\" style=\"color:#1a202c\">Casi clinici<\/a><\/li><\/ul><\/div>\n\n\n<div id=\"bmscience788702451\" style=\"margin-left: auto;margin-right: auto;text-align: center;\"><script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3495866718878812\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display:block;\" data-ad-client=\"ca-pub-3495866718878812\" \ndata-ad-slot=\"4682122636\" \ndata-ad-format=\"auto\" data-full-width-responsive=\"true\"><\/ins>\n<script> \n(adsbygoogle = window.adsbygoogle || []).push({}); \n<\/script>\n<\/div>\n\n\n<div id=\"rtoc-mokuji-wrapper\" class=\"rtoc-mokuji-content frame4 preset2 animation-slide rtoc_open default\" data-id=\"24577\" data-theme=\"eStar\">\n\t\t\t<div id=\"rtoc-mokuji-title\" class=\"rtoc_btn_none rtoc_center\">\n\t\t\t\n\t\t\t<span>Indice dei contenuti<\/span>\n\t\t\t<\/div><ol class=\"rtoc-mokuji decimal_ol level-1\"><li class=\"rtoc-item\"><a href=\"#principali-indicazioni-cliniche-9030f37e-9168-40d0-a80e-4527412f25e5\">Principali indicazioni cliniche<\/a><\/li><li class=\"rtoc-item\"><a href=\"#radiofarmaco-99mtchmpao-46feac09-a7c1-41a4-89e4-255f5feb3e98\">Radiofarmaco: <sup>99m<\/sup>Tc-HMPAO<\/a><\/li><li class=\"rtoc-item\"><a href=\"#precauzioni-operative-15e905f2-3f44-49d8-b71b-4d705d889c5b\">Precauzioni operative<\/a><\/li><li class=\"rtoc-item\"><a href=\"#controllo-di-qualita-della-preparazione-a106f682-004f-4fe3-8a82-bf615acfc365\">Controllo di qualit\u00e0 della preparazione<\/a><\/li><li class=\"rtoc-item\"><a href=\"#procedura-di-radiomarcatura-0463ebf4-84ca-4ed4-97e6-7f09a39d99b9\">Procedura di radiomarcatura<\/a><\/li><li class=\"rtoc-item\"><a href=\"#acquisizione-2bcce220-0002-43f8-8cc6-15581b5a0a6e\">Acquisizione<\/a><\/li><li class=\"rtoc-item\"><a href=\"#analisi-delle-immagini-733d2d92-1d62-467e-ba31-72c96ed9ed46\">Analisi delle immagini<\/a><\/li><li class=\"rtoc-item\"><a href=\"#limiti-e-svantaggi-b95a7e18-16df-45f4-a914-5ebf14c7674d\">Limiti e svantaggi<\/a><\/li><li class=\"rtoc-item\"><a href=\"#risultati-e-osservazioni-526ee50e-7c4a-4ffa-bd4b-d68346fb41b1\">Risultati e osservazioni<\/a><\/li><li class=\"rtoc-item\"><a href=\"#casi-clinici-aa8a32dd-79aa-4645-96c7-4f5330c410fd\">Casi clinici<\/a><\/li><\/ol><\/div><h2 class=\"wp-block-heading\" id=\"principali-indicazioni-cliniche-9030f37e-9168-40d0-a80e-4527412f25e5\"><span class=\"ez-toc-section\" id=\"Principali_indicazioni_cliniche\"><\/span>Principali indicazioni cliniche<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>La scintigrafia con leucociti marcati viene utilizzata per <strong>identificare il focolaio occulto<\/strong> di un\u2019infezione in pazienti con infezione sospetta o nota e <strong>valutare l\u2019estensione della malattia infettiva<\/strong>, una volta confermata la diagnosi.<\/p>\n\n\n\n<p><strong>Indicazioni pi\u00f9 frequenti:<\/strong><\/p>\n\n\n<div id=\"bmscience4238653497\" style=\"float: right;\"><script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3495866718878812\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display:block;\" data-ad-client=\"ca-pub-3495866718878812\" \ndata-ad-slot=\"7361327101\" \ndata-ad-format=\"auto\" data-full-width-responsive=\"true\"><\/ins>\n<script> \n(adsbygoogle = window.adsbygoogle || []).push({}); \n<\/script>\n<\/div>\n\n\n<ul class=\"wp-block-list\">\n<li><strong>osteomielite<\/strong> dello scheletro appendicolare (arti);<\/li>\n\n\n\n<li><strong>infezione di protesi articolari o vascolari<\/strong>, cateteri venosi centrali o altri dispositivi endovascolari;<\/li>\n\n\n\n<li><strong>ascesso post-operatorio<\/strong>;<\/li>\n\n\n\n<li><strong>endocardite<\/strong>;<\/li>\n\n\n\n<li><strong>febbre di origine sconosciuta (FUO)<\/strong>;<\/li>\n\n\n\n<li><strong>piede diabetico<\/strong>, soprattutto in caso di sospetta osteomielite sottostante;<\/li>\n\n\n\n<li><strong>infezioni polmonari<\/strong> in casi selezionati;<\/li>\n\n\n\n<li><strong>malattia infiammatoria intestinale (IBD)<\/strong>, come morbo di Chron, colite ulcerosa, colite infettiva;<\/li>\n\n\n\n<li><strong>infezioni del sistema nervoso centrale<\/strong> (es. encefaliti, ascessi cerebrali).<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"radiofarmaco-99mtchmpao-46feac09-a7c1-41a4-89e4-255f5feb3e98\"><span class=\"ez-toc-section\" id=\"Radiofarmaco_99mTc-HMPAO\"><\/span>Radiofarmaco: <sup>99m<\/sup>Tc-HMPAO<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Il <strong><sup>99m<\/sup>Tc-HMPAO<\/strong>, noto anche come <strong>exametazime<\/strong>, \u00e8 un complesso neutro, lipofilo e a basso peso molecolare. Dal punto di vista strutturale, il tecnezio \u00e8 presente in forma <strong>Tc\u2075\u207a<\/strong>, coordinato con:<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"823\" height=\"381\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-160854.png\" alt=\"\" class=\"wp-image-24579\" style=\"width:323px;height:auto\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-160854.png 823w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-160854-300x139.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-160854-768x356.png 768w\" sizes=\"auto, (max-width: 823px) 100vw, 823px\" \/><\/figure>\n<\/div>\n\n\n<ul class=\"wp-block-list\">\n<li><strong>un gruppo oxo-<\/strong> in posizione apicale;<\/li>\n\n\n\n<li><strong>quattro atomi di azoto<\/strong> ai vertici della base di una <strong>piramide a base quadrata<\/strong>.<\/li>\n<\/ul>\n\n\n\n<p>Grazie alla sua <strong>lipofilia e neutralit\u00e0<\/strong>, \u00e8 in grado di attraversare <strong>passivamente<\/strong> la <strong>barriera emato-encefalica<\/strong> lungo il gradiente di concentrazione.<\/p>\n\n\n\n<p>Dopo la somministrazione endovenosa il composto attraversa le membrane cellulari per semplice <strong>diffusione passiva<\/strong>. All\u2019interno della cellula, viene rapidamente <strong>idrolizzato da esterasi<\/strong> endocellulari, che lo convertono in una forma <strong>idrofila<\/strong> incapace di ritornare all\u2019esterno. Il composto rimane cos\u00ec <strong>intrappolato nei neuroni<\/strong>, determinando una <strong>ritenzione prolungata<\/strong> proporzionale alla <strong>perfusione cerebrale regionale (rCBF)<\/strong> al momento dell\u2019iniezione.<\/p>\n\n\n\n<p><strong><span style=\"text-decoration: underline;\">Uptake cerebrale massimo<\/span><\/strong>: 4-6% dell\u2019attivit\u00e0 somministrata <strong>entro 1 minuto<\/strong>, con <strong>trascurabile riduzione<\/strong> nelle successive 24 ore. Per questo viene sviluppato principalmente per l\u2019esecuzione di <strong>SPECT cerebrale<\/strong> per la valutazione del <strong>flusso ematico cerebrale regionale (rCBF)<\/strong> utilizzato per diagnosi differenziale delle <strong>demenze<\/strong> (es. Alzheimer), <strong>patologie cerebrovascolari<\/strong> e <strong>morte cerebrale<\/strong> (sia con immagini dinamiche precoci che con acquisizione SPECT ritardata), oggi sostituito dal <sup>18<\/sup>F-FDG nella PET.<\/p>\n\n\n<div id=\"bmscience1259582594\" style=\"margin-top: 15px;margin-right: 15px;float: left;\"><a href=\"https:\/\/amzn.to\/44ZclLw\" target=\"_blank\" aria-label=\"Progetto senza titolo\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Progetto-senza-titolo-1.gif\" alt=\"\"  width=\"300\" height=\"300\"   \/><\/a><\/div>\n\n\n<p>Il <sup>99m<\/sup>Tc-HMPAO \u00e8 ampiamente usato attualmente per la <strong>marcatura di leucociti autologhi<\/strong>, impiegati per la <strong>localizzazione scintigrafica di focolai infettivi<\/strong>.<\/p>\n\n\n\n<p>Dopo iniezione EV, il tracciante viene <strong>rapidamente eliminato dal sangue<\/strong> grazie alla <strong>clearance renale (40%)<\/strong> e <strong>epatobiliare (20%)<\/strong>.<\/p>\n\n\n\n<p>La <strong>flessibilit\u00e0 temporale<\/strong> di acquisizione SPECT (da <strong>30 a 60 minuti<\/strong> fino anche a tempi pi\u00f9 tardivi) \u00e8 possibile grazie alla <strong>stabilit\u00e0 intracellulare<\/strong> del tracciante.<\/p>\n\n\n\n<p>Dopo ricostituzione, il tracciante \u00e8 <strong>chimicamente stabile solo per 30 minuti<\/strong>.<\/p>\n\n\n\n<p>Pertanto \u00e8 essenziale <strong>predisporre l\u2019accesso venoso prima della ricostituzione<\/strong>. Il tracciante deve essere <strong>somministrato (o utilizzato per la marcatura)<\/strong> entro questo intervallo di tempo, per evitare risultati non affidabili.<\/p>\n\n\n\n<p><strong>Dosimetria e sicurezza:<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Parametro<\/th><th class=\"has-text-align-center\" data-align=\"center\">Valore (per MBq somministrato)<\/th><\/tr><\/thead><tbody><tr><td><strong>Dose efficace<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">0,0093 mSv\/MBq<\/td><\/tr><tr><td><strong>Organi critici<\/strong>:<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><\/tr><tr><td>Rene<\/td><td class=\"has-text-align-center\" data-align=\"center\">0,034 mGy\/MBq<\/td><\/tr><tr><td>Tiroide<\/td><td class=\"has-text-align-center\" data-align=\"center\">0,026 mGy\/MBq<\/td><\/tr><tr><td>Parete vescicale<\/td><td class=\"has-text-align-center\" data-align=\"center\">0,023 mGy\/MBq<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n<div id=\"bmscience3577284793\" style=\"margin-left: auto;margin-right: auto;text-align: center;\"><div data-id='24153' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento&#8230;<\/p><\/div>\r\n\r\n<\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"precauzioni-operative-15e905f2-3f44-49d8-b71b-4d705d889c5b\"><span class=\"ez-toc-section\" id=\"Precauzioni_operative\"><\/span>Precauzioni operative<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Per garantire la sicurezza del paziente e la qualit\u00e0 della preparazione, la marcatura dei leucociti deve essere effettuata in condizioni <strong>rigorosamente asettiche<\/strong>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>utilizzare solo <strong>reagenti sterili<\/strong>, materiali monouso in plastica sterile e <strong>guanti sterili<\/strong>;<\/li>\n\n\n\n<li>indossare <strong>cuffia e mascherina<\/strong>;<\/li>\n\n\n\n<li>eseguire tutte le operazioni in una <strong>cabina a flusso laminare<\/strong> o in un <strong>isolatore cellulare<\/strong>;<\/li>\n\n\n\n<li><strong>non eseguire mai la marcatura contemporanea<\/strong> di leucociti provenienti da pazienti diversi, per evitare <strong>scambi accidentali<\/strong> tra preparazioni.<\/li>\n<\/ul>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>I leucociti marcati con <sup>99m<\/sup>Tc-HMPAO devono essere <strong>reinfusi il prima possibile<\/strong>, idealmente <strong>entro 1 ora dalla marcatura<\/strong>, previa verifica dell\u2019identit\u00e0 del paziente con <strong>almeno due forme di identificazione<\/strong>.<\/p>\n<\/blockquote>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"controllo-di-qualita-della-preparazione-a106f682-004f-4fe3-8a82-bf615acfc365\"><span class=\"ez-toc-section\" id=\"Controllo_di_qualita_della_preparazione\"><\/span>Controllo di qualit\u00e0 della preparazione<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p><strong>Prima dell\u2019uso clinico (validazione del processo)<\/strong>:<\/p>\n\n\n<div id=\"bmscience1351524371\" style=\"margin-top: 15px;margin-left: 15px;float: right;\"><a href=\"https:\/\/amzn.to\/4exVHa6\" target=\"_blank\" aria-label=\"Version 1.0.0\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/ec79efd8-7b00-4f47-a66b-9a3b5fd0059f.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/ec79efd8-7b00-4f47-a66b-9a3b5fd0059f.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/ec79efd8-7b00-4f47-a66b-9a3b5fd0059f-180x150.jpg 180w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" width=\"300\" height=\"250\"   \/><\/a><\/div>\n\n\n<ul class=\"wp-block-list\">\n<li><strong>sterilit\u00e0<\/strong>;<\/li>\n\n\n\n<li><strong>assenza di pirogeni<\/strong>;<\/li>\n\n\n\n<li><strong>efficienza di marcatura WBC &gt;50%<\/strong>;<\/li>\n\n\n\n<li><strong>vitalit\u00e0 cellulare &gt;98%<\/strong> (test del blu di tripano);<\/li>\n\n\n\n<li><strong>test di recupero delle sottopopolazioni cellulari<\/strong>;<\/li>\n\n\n\n<li><strong>saggi di chemotassi o fagocitosi<\/strong>;<\/li>\n\n\n\n<li><strong>efflusso del <sup>99m<\/sup>Tc dai leucociti marcati<\/strong>.<\/li>\n<\/ul>\n\n\n\n<p><strong>Durante l\u2019uso clinico di routine<\/strong>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>efficienza di marcatura (<strong>attesa 40-80%<\/strong>);<\/li>\n\n\n\n<li><strong>ispezione visiva<\/strong> della sospensione marcata;<\/li>\n\n\n\n<li>valutazione della <strong>captazione polmonare precoce<\/strong> e del <strong>rapporto fegato\/milza<\/strong>.<\/li>\n<\/ul>\n\n\n\n<p><strong>Controlli periodici<\/strong>: verifica della <strong>sterilit\u00e0<\/strong> secondo i criteri della Farmacopea. In caso di positivit\u00e0, ripetere <strong>interamente il processo di validazione.<\/strong><\/p>\n\n\n<div id=\"bmscience177638654\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/4swoans\" target=\"_blank\" aria-label=\"Version 1.0.0\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/66e6ea97-5fdb-4e3b-ac4e-c60c1bc75ed2.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/66e6ea97-5fdb-4e3b-ac4e-c60c1bc75ed2.jpg 2191w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/66e6ea97-5fdb-4e3b-ac4e-c60c1bc75ed2-300x65.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/66e6ea97-5fdb-4e3b-ac4e-c60c1bc75ed2-1024x222.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/66e6ea97-5fdb-4e3b-ac4e-c60c1bc75ed2-768x166.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/66e6ea97-5fdb-4e3b-ac4e-c60c1bc75ed2-1536x332.jpg 1536w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/66e6ea97-5fdb-4e3b-ac4e-c60c1bc75ed2-2048x443.jpg 2048w\" sizes=\"auto, (max-width: 2191px) 100vw, 2191px\" width=\"2191\" height=\"474\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"procedura-di-radiomarcatura-0463ebf4-84ca-4ed4-97e6-7f09a39d99b9\"><span class=\"ez-toc-section\" id=\"Procedura_di_radiomarcatura\"><\/span>Procedura di radiomarcatura<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n<div id=\"bmscience2060515277\" style=\"margin-top: 15px;margin-left: 15px;float: right;\"><a href=\"https:\/\/amzn.to\/3HvxfJO\" target=\"_blank\" aria-label=\"Version 1.0.0\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/e9df8a88-7895-4804-8211-20398110afe0.jpeg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/e9df8a88-7895-4804-8211-20398110afe0.jpeg 640w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/e9df8a88-7895-4804-8211-20398110afe0-80x300.jpeg 80w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/e9df8a88-7895-4804-8211-20398110afe0-273x1024.jpeg 273w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/05\/e9df8a88-7895-4804-8211-20398110afe0-546x2048.jpeg 546w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" width=\"180\" height=\"675\"   \/><\/a><\/div>\n\n\n<ol class=\"wp-block-list\">\n<li><strong><span style=\"text-decoration: underline;\">Prelievo e isolamento dei leucociti<\/span><\/strong>:<br>prelevare <strong>51 mL di sangue<\/strong> del paziente utilizzando una <strong>siringa da 60 mL<\/strong> contenente <strong>9 mL di soluzione anticoagulante ACD<\/strong>, con <strong>aghi \u226520G<\/strong>, e poi miscelare delicatamente sangue e ACD.<br>Per una <strong>buona efficienza di marcatura (LE)<\/strong>, sono necessari <strong>almeno 2\u00d710\u2078 leucociti<\/strong>. In pazienti <strong>neutropenici<\/strong>, potrebbe essere necessario un secondo prelievo.<\/li>\n\n\n\n<li><strong><span style=\"text-decoration: underline;\">Preparazione del plasma privo di cellule (CFP)<\/span><\/strong>:<br>centrifugare <strong>15 dei 60 mL<\/strong> del campione sangue\/ACD a <strong>2000 g per 10 minuti<\/strong> a temperatura ambiente.<br>Prelevare il <strong>surnatante (CFP)<\/strong> per usarlo nella marcatura e nella risospensione cellulare.<br>In alternativa al CFP si possono utilizzare <strong>PBS (pH 7.4)<\/strong> o <strong>soluzione fisiologica (NaCl 0,9%)<\/strong>.<\/li>\n\n\n\n<li><strong><span style=\"text-decoration: underline;\">Isolamento dei leucociti misti<\/span><\/strong>:<br>lasciare sedimentare spontaneamente i <strong>restanti 45 mL<\/strong> della miscela sangue\/ACD.<br>Per accelerare la sedimentazione degli eritrociti, aggiungere <strong>amido idrossietilico (HES 10%)<\/strong> ad alto peso molecolare (HES 200\/0.5 o 200\/0.6).<\/li>\n\n\n\n<li><strong><span style=\"text-decoration: underline;\">Isolamento opzionale dei granulociti<\/span><\/strong> (opzionale):<br>i granulociti possono essere separati dai leucociti misti mediante <strong>centrifugazione a gradiente di densit\u00e0<\/strong>.<\/li>\n\n\n\n<li><strong><span style=\"text-decoration: underline;\">Marcatura dei leucociti con <sup>99m<\/sup>Tc-HMPAO<\/span><\/strong>:\n<ul class=\"wp-block-list\">\n<li>preparare il radiofarmaco <strong>immediatamente prima dell\u2019uso<\/strong>, utilizzando <strong><sup>99m<\/sup>Tc-pertecnetato appena eluato<\/strong>, <strong>senza stabilizzanti n\u00e9 PBS<\/strong>;<\/li>\n\n\n\n<li>aggiungere <strong>750-1.000 MBq<\/strong> di <sup>99m<\/sup>Tc-HMPAO alla sospensione leucocitaria (mista o granulociti purificati);<\/li>\n\n\n\n<li>incubare per <strong>10 minuti a temperatura ambiente<\/strong>, agitando <strong>delicatamente<\/strong> per evitare la sedimentazione cellulare;<\/li>\n\n\n\n<li>usare <strong>1 mL di soluzione di <sup>99m<\/sup>Tc-HMPAO<\/strong> per ottenere una marcatura pi\u00f9 efficiente (LE), anche se alcuni kit commerciali indicano 5 mL.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong><span style=\"text-decoration: underline;\">Separazione e risospensione<\/span><\/strong>:\n<ul class=\"wp-block-list\">\n<li>aggiungere <strong>10 mL di CFP<\/strong> (minimo 3 mL) alla miscela dopo l\u2019incubazione;<\/li>\n\n\n\n<li>centrifugare a <strong>150 g per 5 minuti<\/strong>;<\/li>\n\n\n\n<li>aspirare il surnatante (contenente il radiofarmaco non legato) e misurare la radioattivit\u00e0 residua nel pellet e nel surnatante per <strong>calcolare l\u2019efficienza di marcatura (LE)<\/strong>;<\/li>\n\n\n\n<li>risospendere il pellet in <strong>3\u20135 mL di CFP<\/strong>;<\/li>\n\n\n\n<li>reinfondere <strong>entro 1 ora<\/strong> dalla marcatura.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>\ud83d\udca1 L\u2019attivit\u00e0 consigliata da somministrare \u00e8 <strong>370\u2013740 MBq<\/strong>.<\/p>\n<\/blockquote>\n\n\n<div id=\"bmscience1775628263\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/4swoans\" target=\"_blank\" aria-label=\"d64c165f-44d2-415e-ab64-c07f02417696._CR260,631,2362,472_SX1920_\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/d64c165f-44d2-415e-ab64-c07f02417696._CR2606312362472_SX1920_.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/d64c165f-44d2-415e-ab64-c07f02417696._CR2606312362472_SX1920_.jpg 1920w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/d64c165f-44d2-415e-ab64-c07f02417696._CR2606312362472_SX1920_-300x60.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/d64c165f-44d2-415e-ab64-c07f02417696._CR2606312362472_SX1920_-1024x205.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/d64c165f-44d2-415e-ab64-c07f02417696._CR2606312362472_SX1920_-768x154.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2026\/01\/d64c165f-44d2-415e-ab64-c07f02417696._CR2606312362472_SX1920_-1536x307.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\" width=\"1920\" height=\"384\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"acquisizione-2bcce220-0002-43f8-8cc6-15581b5a0a6e\"><span class=\"ez-toc-section\" id=\"Acquisizione\"><\/span>Acquisizione<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Dopo la <strong>reinfusione EV <\/strong>di leucociti autologhi marcati con <sup>99m<\/sup>Tc-HMPAO, si eseguono acquisizioni <strong>planari sequenziali<\/strong> e <strong>SPECT\/CT<\/strong> come segue:<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th class=\"has-text-align-center\" data-align=\"center\">Tempo post-iniezione<\/th><th>Tipo di acquisizione<\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>30 min<\/strong><\/td><td>Whole-body + Planare del distretto da studiare<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>4-6 h<\/strong><\/td><td>Planare + <strong>SPECT\/CT del distretto da studiare<\/strong><\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>20-24 h<\/strong><br>(se necessario)<\/td><td>Planare + SPECT\/CT ripetuto se immagini a 6 h sono negative o dubbie<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>\u00c8 possibile effettuare <strong>acquisizioni SPECT\/CT aggiuntive<\/strong> nello stesso time point in caso di dubbi.<\/p>\n\n\n\n<p>La scintigrafia \u00e8 <strong>positiva per infezione<\/strong> quando:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u00e8 presente <strong>almeno un focolaio di captazione anomala<\/strong>;<\/li>\n\n\n\n<li>si osserva un <strong>aumento progressivo dell\u2019attivit\u00e0 nel tempo<\/strong> (dalla fase precoce a quella tardiva).<\/li>\n<\/ul>\n\n\n<div id=\"bmscience2219940160\" style=\"margin-top: 15px;margin-left: 15px;float: right;\"><div style=\"\r\n  width: 300px;\r\n  margin: 0 auto;\r\n  text-align: center;\r\n\">\r\n<div data-id='24174' class='amazon-auto-links aal-js-loading'><p class='now-loading-placeholder'>Caricamento&#8230;.<\/p><\/div><\/div><\/div>\n\n\n<p>La <strong>SPECT\/CT<\/strong> \u00e8 essenziale per superare i limiti delle immagini planari e migliorare la <strong>localizzazione e l&#8217;accuratezza diagnostica<\/strong>, specialmente nell\u2019<strong>endocardite infettiva (IE)<\/strong>, in infezioni da <strong>CIED<\/strong> (dispositivi elettronici impiantabili cardiaci), in pazienti con <strong>LVAD<\/strong> (left <em>ventricular assist device<\/em>).<\/p>\n\n\n\n<p>Se si utilizza una valutazione semi-quantitativa, \u00e8 fondamentale correggere le immagini per il decadimento isotopico.<\/p>\n\n\n\n<p>In caso di endocardite la SPECT\/CT deve coprire il <strong>torace<\/strong>.<\/p>\n\n\n\n<p>In caso di infezioni da dispositivi intracardiaci (CIEDs) o sistemi di assistenza ventricolare sinistra (LVAD): devono essere inclusi <strong>torace e addome superiore<\/strong>, considerando tutte le possibili sedi dell&#8217;origine infettiva (es. addome).<\/p>\n\n\n\n<p>I focolai di captazione vengono classificati come:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>cardiaci<\/strong>;<\/li>\n\n\n\n<li><strong>extra-cardiaci<\/strong> (es. embolie settiche nei polmoni visibili come &#8220;hot spot&#8221;, o in milza\/colonna vertebrale come &#8220;cold spot&#8221;).<\/li>\n<\/ul>\n\n\n<div id=\"bmscience2421770541\" style=\"margin-top: 15px;margin-right: 15px;float: left;\"><a href=\"https:\/\/amzn.to\/4kmxOna\" target=\"_blank\" aria-label=\"Lavazza\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Lavazza.gif\" alt=\"\"  width=\"300\" height=\"300\"   \/><\/a><\/div>\n\n\n<p>I \u201c<strong><em>cold spot<\/em><\/strong>\u201d non sono di per s\u00e9 indicativi di embolie settiche e richiedono conferma tramite TC o RM, poich\u00e9 possono essere presenti in altre condizioni cliniche (es. metastasi, angiomi, fratture vertebrali).<\/p>\n\n\n\n<p>Questa metodica \u00e8 particolarmente utile per <strong>escludere infezioni<\/strong> in sedi ossee precedentemente alterate, come in condizioni post-chirurgiche, post-traumatiche o nelle infezioni scheletriche del piede diabetico.<\/p>\n\n\n\n<p>La <strong>combinazione tra scintigrafia con leucociti marcati e scintigrafia ossea<\/strong> offre una <strong>migliore accuratezza diagnostica<\/strong> rispetto alla sola scintigrafia con leucociti, e consente di <strong>localizzare con precisione i focolai patologici<\/strong>, distinguendo quindi l&#8217;infiammazione settica da quella asettica.<\/p>\n\n\n\n<p>Nel caso delle <strong>IBD<\/strong>, la scintigrafia con leucociti marcati comporta un&#8217;acquisizione precoce a distanza di 30-45 minuti e quindi acquisizioni successive a 90, 120 e 180 minuti. In questo periodo il transito non specifico di radioattivit\u00e0 all&#8217;interno del lume intestinale risulta modesto e tale da non porre problemi interpretativi. <\/p>\n\n\n<div id=\"bmscience3949828275\" style=\"margin-left: auto;margin-right: auto;text-align: center;\"><script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3495866718878812\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display:block;\" data-ad-client=\"ca-pub-3495866718878812\" \ndata-ad-slot=\"4682122636\" \ndata-ad-format=\"auto\" data-full-width-responsive=\"true\"><\/ins>\n<script> \n(adsbygoogle = window.adsbygoogle || []).push({}); \n<\/script>\n<\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"analisi-delle-immagini-733d2d92-1d62-467e-ba31-72c96ed9ed46\"><span class=\"ez-toc-section\" id=\"Analisi_delle_immagini\"><\/span>Analisi delle immagini<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>L\u2019analisi delle immagini SPECT\/CT prevede:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>ispezione visiva <\/strong>per evitare disallineamenti tra SPECT e CT;<\/li>\n\n\n\n<li>confronto tra immagini <strong>corrette <\/strong>e <strong>non corrette<\/strong> per l\u2019attenuazione;<\/li>\n\n\n\n<li><strong>ricostruzione <\/strong>con e senza correzione dell\u2019attenuazione per rilevare artefatti.<\/li>\n<\/ul>\n\n\n\n<p>L\u2019acquisizione SPECT\/CT \u00e8 fondamentale, soprattutto per valutare con precisione l\u2019estensione dell\u2019infezione, ovvero se l\u2019infezione \u00e8 confinata all\u2019osso e al midollo osseo o coinvolge anche i tessuti molli adiacenti. Questa distinzione rappresenta la base ottimale per una corretta gestione clinica, in particolare in condizioni specifiche come il <strong>piede diabetico<\/strong>.<\/p>\n\n\n\n<div class=\"wp-block-advgb-adv-tabs advgb-tabs-wrapper advgb-tab-horz-desktop advgb-tab-vert-tablet advgb-tab-stack-mobile advgb-tabs-725f5e6f-7dbf-44fd-979f-28d8d4a7c7f1\" data-tab-active=\"0\"><ul class=\"advgb-tabs-panel\" role=\"tablist\"><li class=\"advgb-tab advgb-tab-active\" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-0\" aria-controls=\"advgb-tab-panel-_0920c1-73-0\" role=\"tab\" aria-selected=\"true\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Protesi aortica e mitralica<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-1\" aria-controls=\"advgb-tab-panel-_0920c1-73-1\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Embolia settica<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-2\" aria-controls=\"advgb-tab-panel-_0920c1-73-2\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Infezione protesi vascolare<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-3\" aria-controls=\"advgb-tab-panel-_0920c1-73-3\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Infezione protesi vascolare<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-4\" aria-controls=\"advgb-tab-panel-_0920c1-73-4\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Osteomielite<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-5\" aria-controls=\"advgb-tab-panel-_0920c1-73-5\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Osteomielite<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-6\" aria-controls=\"advgb-tab-panel-_0920c1-73-6\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Artrite settica<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-7\" aria-controls=\"advgb-tab-panel-_0920c1-73-7\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Osteomielite frontale<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-8\" aria-controls=\"advgb-tab-panel-_0920c1-73-8\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Piede diabetico<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-9\" aria-controls=\"advgb-tab-panel-_0920c1-73-9\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Piede diabetico<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-10\" aria-controls=\"advgb-tab-panel-_0920c1-73-10\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>HMPAO vs albumina<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-11\" aria-controls=\"advgb-tab-panel-_0920c1-73-11\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Infezione protesi<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-12\" aria-controls=\"advgb-tab-panel-_0920c1-73-12\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Infezione protesi<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-13\" aria-controls=\"advgb-tab-panel-_0920c1-73-13\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Morbo di Chron<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-14\" aria-controls=\"advgb-tab-panel-_0920c1-73-14\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Morbo di Chron<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_0920c1-73-15\" aria-controls=\"advgb-tab-panel-_0920c1-73-15\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Ascesso epatico<\/strong><\/span><\/button><\/li><\/ul><div class=\"advgb-tab-body-wrapper\" style=\"border-style:solid;border-width:1px;border-radius:10px\">\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-0\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-0\" tabindex=\"0\"><span><strong>Protesi aortica e mitralica<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-0\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee3547133f7&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee3547133f7\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"619\" height=\"702\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-164318.png\" alt=\"\" class=\"wp-image-24582\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-164318.png 619w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-164318-265x300.png 265w\" sizes=\"auto, (max-width: 619px) 100vw, 619px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<pre class=\"wp-block-verse\"><strong>Scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO<\/strong> in un paziente portatore di protesi meccaniche aortica e mitralica, con febbre, PCR e VES aumentate e fattore reumatoide negativo. Nonostante ecocardiografie negative (transtoracica e transesofagea), l\u2019emocoltura ha rilevato <em>Enterococcus faecalis<\/em>. La SPECT\/CT evidenzia un focolaio di aumentata captazione nella regione perivalvolare aortica mediale, come mostrato nelle proiezioni MIP, assiale, coronale, sagittale e nella ricostruzione 3D. L\u2019imaging planare risulta insufficiente a diagnosticare l\u2019endocardite infettiva, poich\u00e9 l\u2019attivit\u00e0 dello sterno maschera la captazione valvolare; la SPECT\/CT, invece, permette una localizzazione pi\u00f9 precisa e migliora significativamente l\u2019accuratezza diagnostica.<\/pre>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-1\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-1\" tabindex=\"0\"><span><strong>Embolia settica<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-1\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee354713af0&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee354713af0\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"525\" height=\"695\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-164858.png\" alt=\"\" class=\"wp-image-24583\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-164858.png 525w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-164858-227x300.png 227w\" sizes=\"auto, (max-width: 525px) 100vw, 525px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<pre class=\"wp-block-verse\">Esempi di diversi pattern di captazione in pazienti con <strong>endocardite infettiva<\/strong> e <strong>embolia settica<\/strong>. Nel pannello superiore, la PET\/CT con [<sup>18<\/sup>F]FDG mostra infezioni metastatiche a milza e colonna vertebrale, con aumento del tracciante nella milza corrispondente a una zona ipodensa a forma cuneiforme alla TC, e incremento della captazione nella colonna.<br>Nel pannello inferiore, l\u2019imaging SPECT\/CT con <sup>99m<\/sup>Tc-HMPAO-WBC evidenzia aree focali \u201cfredde\u201d nella milza (a sinistra) e nella colonna, dovute all\u2019elevato accumulo fisiologico dei leucociti radiomarcati in entrambi i distretti.<\/pre>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-2\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-2\" tabindex=\"0\"><span><strong>Infezione protesi vascolare<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-2\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471409f&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471409f\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"826\" height=\"745\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-171033.png\" alt=\"\" class=\"wp-image-24585\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-171033.png 826w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-171033-300x271.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-171033-768x693.png 768w\" sizes=\"auto, (max-width: 826px) 100vw, 826px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<pre class=\"wp-block-verse\"><strong>Scintigrafia con leucociti marcati 99mTc-HMPAO in un paziente con sospetta infezione tardiva di protesi vascolare aorto-bisiliaca<\/strong>, manifestatasi con cellulite, erisipela all\u2019arto inferiore sinistro e febbre. Il tampone ha isolato <em>Enterobacter sakazakii <\/em>ed <em>E. coli<\/em>.<br>Le immagini planari anteriori e posteriori (a<sub>1<\/sub>\u2013a<sub>2<\/sub> e c<sub>1<\/sub>\u2013c<sub>2<\/sub>) acquisite a 30 minuti e 2 ore dopo l\u2019infusione evidenziano una persistente captazione alla protesi vascolare, seppur meno intensa rispetto al basale. Le sezioni coronali e assiali (b<sub>1<\/sub>\u2013b<sub>2<\/sub> e d<sub>1<\/sub>\u2013d<sub>2<\/sub>) mostrano la TC (a sinistra) e le corrispondenti sezioni SPECT\/CT fuse (a destra). <\/pre>\n<\/div>\n<\/div>\n\n\n\n<p>Il paziente \u00e8 stato sottoposto a debridement e sostituzione in situ della protesi con vene femorali autologhe. L\u2019esame microbiologico ha rivelato <em>Candida albicans<\/em>.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-3\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-3\" tabindex=\"0\"><span><strong>Infezione protesi vascolare<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-3\" style=\"display:none\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee354714606&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee354714606\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"549\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-171552-1024x549.png\" alt=\"\" class=\"wp-image-24586\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-171552-1024x549.png 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-171552-300x161.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-171552-768x412.png 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-171552.png 1153w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<pre class=\"wp-block-verse\"><strong>Scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO in un paziente con sospetta infezione tardiva di protesi vascolare ilio-femorale e femoro-poplitea destra<\/strong>.<br>Le immagini planari anteriori e posteriori (pannello in alto a sinistra), acquisite a 30 minuti e a 4 ore, mostrano un aumento della captazione lungo i segmenti femorali. L\u2019infezione \u00e8 risultata di origine polimicrobica.<br>Il pannello inferiore sinistro presenta la ricostruzione tridimensionale SPECT\/CT, evidenziando con maggiore precisione l\u2019accumulo di leucociti radiomarcati lungo tutto l\u2019innesto vascolare, inclusa la regione inguinale destra. I pannelli di destra mostrano sezioni assiali e coronali a diversi livelli (da sinistra a destra: immagini SPECT, TC, e SPECT\/CT fuse) che localizzano l\u2019accumulo focale dei leucociti lungo la protesi sia in sede iliaca che femorale.<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-4\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-4\" tabindex=\"0\"><span><strong>Osteomielite<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-4\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee354714a4d&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee354714a4d\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"721\" height=\"1024\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/osteomielite-721x1024.jpg\" alt=\"\" class=\"wp-image-24599\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/osteomielite-721x1024.jpg 721w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/osteomielite-211x300.jpg 211w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/osteomielite-768x1091.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/osteomielite.jpg 867w\" sizes=\"auto, (max-width: 721px) 100vw, 721px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<pre class=\"wp-block-verse\"><strong>Scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO eseguita in un paziente con osteomielite della tibia sinistra per valutarne l\u2019estensione<\/strong>.<br>Il pannello superiore mostra le immagini planari a 24 ore (anteriore e posteriore) con accumulo evidente dei leucociti radiomarcati nella diafisi della tibia sinistra.<br>Il pannello inferiore con immagini SPECT\/CT fuse consente una valutazione precisa dell\u2019estensione dell\u2019infezione ossea, con coinvolgimento anche dei tessuti molli adiacenti.<\/pre>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-5\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-5\" tabindex=\"0\"><span><strong>Osteomielite<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-5\" style=\"display:none\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee354714f7d&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee354714f7d\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"550\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-174125-1024x550.png\" alt=\"\" class=\"wp-image-24600\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-174125-1024x550.png 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-174125-300x161.png 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-174125-768x412.png 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-174125.png 1026w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<pre class=\"wp-block-verse\"><strong>Scintigrafia con leucociti marcati<sup> 99m<\/sup>Tc-HMPAO eseguita in due momenti diversi in un paziente con osteomielite della tibia destra<\/strong>.<br>Il pannello di sinistra mostra immagini SPECT\/CT fuse acquisite per confermare il sospetto clinico, evidenziando un chiaro accumulo di leucociti radiomarcati localizzato al sito dell\u2019infezione, confinata all\u2019osso e al midollo osseo.<br>Il pannello di destra mostra le immagini SPECT\/CT fuse acquisite dopo la conclusione della terapia antibiotica, documentando la scomparsa del focolaio di accumulo anomalo, indicativa di risoluzione dell\u2019infezione.<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-6\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-6\" tabindex=\"0\"><span><strong>Artrite settica<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-6\" style=\"display:none\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee354715365&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee354715365\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"366\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/infezione-piede-destro-1-1024x366.jpg\" alt=\"\" class=\"wp-image-24602\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/infezione-piede-destro-1-1024x366.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/infezione-piede-destro-1-300x107.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/infezione-piede-destro-1-768x274.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/infezione-piede-destro-1.jpg 1028w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<pre class=\"wp-block-verse\"><strong>Scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO acquisita a 4 ore dall'iniezione in un paziente con sospetta infezione al piede destro<\/strong>.<br>Il pannello di sinistra mostra le immagini SPECT\/CT fuse in proiezioni assiale, sagittale e coronale, evidenziando un accumulo focale di leucociti radiomarcati nell\u2019articolazione talonavicolare destra, compatibile con artrite settica.<br>Il pannello di destra presenta una ricostruzione 3D delle immagini SPECT\/CT fuse degli arti inferiori, che consente di localizzare con precisione il sito infettivo.<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-7\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-7\" tabindex=\"0\"><span><strong>Osteomielite frontale<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-7\" style=\"display:none\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee354715742&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee354715742\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"589\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/aedg-1024x589.jpg\" alt=\"\" class=\"wp-image-24603\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/aedg-1024x589.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/aedg-300x172.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/aedg-768x442.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/aedg.jpg 1028w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<pre class=\"wp-block-verse\"><strong>Scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO eseguita in un paziente con sospetta osteomielite frontale<\/strong>.<br>Il pannello sinistro mostra immagini planari acquisite 4 ore dopo l\u2019iniezione: quella superiore in proiezione anteriore e quella inferiore in laterale sinistra, entrambe evidenziano un accumulo focale di leucociti radiomarcati nella regione frontale.<br>Il pannello destro presenta immagini SPECT\/CT fuse (sagittale a sinistra, assiale a destra), che mostrano una marcata captazione nel seno frontale, compatibile con processo infettivo in atto.<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-8\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-8\" tabindex=\"0\"><span><strong>Piede diabetico<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-8\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:60%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee354715e63&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee354715e63\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"995\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Piede-diabetico-1024x995.jpg\" alt=\"\" class=\"wp-image-24589\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Piede-diabetico-1024x995.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Piede-diabetico-300x292.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Piede-diabetico-768x746.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Piede-diabetico.jpg 1028w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\">\n<pre class=\"wp-block-verse\"><strong>Scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO eseguita in un paziente diabetico con sospetta osteomielite del dito del piede destro<\/strong>.<br>Le immagini sagittali mostrano la sezione TC (in alto a sinistra), SPECT (in alto a destra) e la fusione SPECT\/CT (in basso a sinistra), evidenziando un accumulo selettivo di leucociti radiomarcati nella struttura ossea del dito.<br>Il pannello inferiore destro mostra l\u2019immagine MIP (<em>Maximum Intensity Projection<\/em>), utile per la localizzazione complessiva del processo infettivo.<\/pre>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-9\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-9\" tabindex=\"0\"><span><strong>Piede diabetico<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-9\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:60%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee3547163bf&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee3547163bf\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"977\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Piede-diabetico-2-1024x977.jpg\" alt=\"\" class=\"wp-image-24606\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Piede-diabetico-2-1024x977.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Piede-diabetico-2-300x286.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Piede-diabetico-2-768x733.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Piede-diabetico-2.jpg 1028w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\">\n<pre class=\"wp-block-verse\"><strong>Scintigrafia SPECT\/CT con leucociti marcati <sup>99m<\/sup>Tc-HMPAO eseguita in un paziente diabetico con ulcera plantare destra e sospetta osteomielite del piede<\/strong>.<br>Le sezioni in diverse proiezioni mostrano che il focolaio di accumulo dei leucociti radiomarcati \u00e8 limitato ai tessuti molli, escludendo il coinvolgimento osseo e dunque l\u2019osteomielite.<br>Il pannello superiore mostra le immagini SPECT, quello centrale la TC, e quello inferiore le immagini fuse SPECT\/CT.<\/pre>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-10\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-10\" tabindex=\"0\"><span><strong>HMPAO vs albumina<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-10\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"606\" height=\"346\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-175511.png\" alt=\"\" class=\"wp-image-24607\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-175511.png 606w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-175511-300x171.png 300w\" sizes=\"auto, (max-width: 606px) 100vw, 606px\" \/><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<pre class=\"wp-block-verse\"><strong>Scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO<\/strong> (pannello sinistro) in un paziente con sospetta osteomielite della tibia sinistra. L\u2019immagine planare mostra un lieve accumulo di leucociti radiomarcati nella porzione prossimale e media della diafisi tibiale, compatibile con un processo infiammatorio senza segni di infezione acuta.<br>Il pannello destro mostra la <strong>scintigrafia con <sup>99m<\/sup>Tc-albumina nanocolloidale<\/strong>, con captazione nello stesso sito della precedente accumulazione, confermando la normale funzionalit\u00e0 del midollo osseo e quindi escludendo la presenza di osteomielite acuta.<\/pre>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-11\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-11\" tabindex=\"0\"><span><strong>Infezione protesi<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-11\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee354716b1b&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee354716b1b\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"766\" height=\"702\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-180043.png\" alt=\"\" class=\"wp-image-24609\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-180043.png 766w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-180043-300x275.png 300w\" sizes=\"auto, (max-width: 766px) 100vw, 766px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<pre class=\"wp-block-verse\"><strong>Scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO eseguita in un paziente portatore di protesi bilaterale dell\u2019anca<\/strong>, con dolore persistente e compromissione funzionale dell\u2019anca destra.<br>Le immagini planari acquisite a 3 e 20 ore post-iniezione (pannello superiore) mostrano accumulo di leucociti radiomarcati nei tessuti molli periprotesici dell\u2019anca destra.<br>Le immagini SPECT\/CT fuse (assiale a sinistra, sagittale al centro, coronale a destra; pannello inferiore) evidenziano che l\u2019infezione dei tessuti molli \u00e8 in continuit\u00e0 con l\u2019impianto protesico, reperto compatibile con la presenza di ascesso.<\/pre>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-12\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-12\" tabindex=\"0\"><span><strong>Infezione protesi<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-12\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee354717069&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee354717069\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"488\" height=\"705\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-180536.png\" alt=\"\" class=\"wp-image-24610\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-180536.png 488w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-180536-208x300.png 208w\" sizes=\"auto, (max-width: 488px) 100vw, 488px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<pre class=\"wp-block-verse\">Valutazione scintigrafica in un paziente sottoposto a <strong>protesi totale di ginocchio sinistro<\/strong> un anno prima, con dolore, edema e segni locali di infiammazione. Il pannello superiore mostra la fase vascolare (\u201c<em>blood pool<\/em>\u201d) e le acquisizioni ritardate a 3 ore della <strong>scintigrafia ossea trifasica con <sup>99m<\/sup>Tc-MDP<\/strong>, indicanti edema e rimodellamento osseo attivo, suggestivi di infiammazione ma non conclusivi per infezione.<br>Il pannello centrale mostra le acquisizioni a 3 e 20 ore durante <strong>scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO<\/strong>, evidenziando accumulo focale al ginocchio sinistro.<br>Le immagini SPECT\/CT fuse (assiale a sinistra, sagittale al centro, coronale a destra; pannello inferiore) rivelano coinvolgimento osseo del compartimento laterale del ginocchio, del piatto tibiale laterale, del condilo femorale laterale e della borsa infrapatellare.<\/pre>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-13\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-13\" tabindex=\"0\"><span><strong>Morbo di Chron<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-13\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471759b&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471759b\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"749\" height=\"555\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-202818.png\" alt=\"\" class=\"wp-image-24611\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-202818.png 749w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Screenshot-2025-07-13-202818-300x222.png 300w\" sizes=\"auto, (max-width: 749px) 100vw, 749px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<pre class=\"wp-block-verse\"><strong>Studio scintigrafico con leucociti marcati con <sup>99m<\/sup>Tc in una donna di 37 anni affetta da malattia di Crohn <\/strong>con recente riacutizzazione dei sintomi.<br>Immagini anteriori acquisite ad 1 ora (<strong>A<\/strong>): evidenziano captazione del tracciante nel ileo distale e nel colon ascendente. A 3 ore (<strong>B<\/strong>): mostrano un pattern di attivit\u00e0 intestinale simile, confermando la persistenza del processo infiammatorio.<\/pre>\n<\/div>\n<\/div>\n\n\n\n<pre class=\"wp-block-verse\">Il tipico aspetto della scintigrafia con <sup>99m<\/sup>Tc-WBC nella malattia infiammatoria intestinale (IBD) \u00e8 una captazione positiva a 1 e 3 ore. Dopo le 3\u20134 ore, pu\u00f2 comparire attivit\u00e0 intestinale non specifica, che pu\u00f2 rendere pi\u00f9 difficile l\u2019interpretazione.<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- header-active\" id=\"advgb-tab-panel-_0920c1-73-14\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-14\" tabindex=\"0\"><span><strong>Morbo di Chron<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-14\" style=\"display:block\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee354717b19&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee354717b19\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"755\" height=\"578\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/chron-2.jpg\" alt=\"\" class=\"wp-image-24597\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/chron-2.jpg 755w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/chron-2-300x230.jpg 300w\" sizes=\"auto, (max-width: 755px) 100vw, 755px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\">\n<pre class=\"wp-block-verse\"><strong>Studio scintigrafico con leucociti marcati con <sup>99m<\/sup>Tc in una donna di 23 anni affetta da malattia di Crohn<\/strong>.<br>Immagini anteriori acquisite ad 1 ora (<strong>A<\/strong>): evidenziano captazione del tracciante nel ileo distale, nel colon trasverso e nel colon discendente. A 3 ore (<strong>B<\/strong>): il pattern di attivit\u00e0 intestinale \u00e8 simile, ma con maggiore intensit\u00e0 nella flessura splenica e nel colon discendente<br>Questo andamento temporale \u00e8 tipico della malattia infiammatoria intestinale, con captazione persistente e crescente nelle aree colpite.<\/pre>\n<\/div>\n<\/div>\n\n\n\n<pre class=\"wp-block-verse\">L\u2019attivit\u00e0 intestinale non specifica a 24 ore nelle scintigrafie con leucociti marcati con <sup>99m<\/sup>Tc pu\u00f2 causare <strong>problemi interpretativi<\/strong>, rendendo difficile distinguere tra infiammazione fisiologica e processi patologici.<br>Se si sospetta un ascesso, \u00e8 preferibile utilizzare<strong> leucociti marcati con <sup>111<\/sup>In<\/strong>, poich\u00e9 questo radiofarmaco presenta una biodistribuzione intestinale pi\u00f9 stabile e una maggiore specificit\u00e0 per i processi infettivi profondi, riducendo il rischio di falsi positivi legati all\u2019attivit\u00e0 intestinale tardiva.<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_0920c1-73-15\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_0920c1-73-15\" tabindex=\"0\"><span><strong>Ascesso epatico<\/strong><\/span><\/div><div class=\"advgb-tab-_0920c1-73 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_0920c1-73-15\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:60%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471807f&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471807f\" class=\"wp-block-image alignfull size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"760\" height=\"410\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Ascesso-sottepatico.jpg\" alt=\"\" class=\"wp-image-24598\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Ascesso-sottepatico.jpg 760w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/Ascesso-sottepatico-300x162.jpg 300w\" sizes=\"auto, (max-width: 760px) 100vw, 760px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\">\n<pre class=\"wp-block-verse\"><strong>Studio scintigrafico con leucociti marcati con <sup>99m<\/sup>Tc in un paziente sottoposto a trapianto di fegato<\/strong>.<br>Le immagini anteriori (A e B) evidenziano una captazione localizzata nel quadrante subepatico destro, visibile solo nella proiezione anteriore (indicata dalla freccia). Questo reperto \u00e8 altamente suggestivo di <strong>ascesso subepatico<\/strong>, una complicanza infettiva post-trapianto che pu\u00f2 essere difficile da rilevare con altre metodiche.<\/pre>\n<\/div>\n<\/div>\n<\/div><\/div>\n<\/div><\/div>\n\n\n<div id=\"bmscience1860677792\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/4khcq3s\" target=\"_blank\" aria-label=\"Cattura\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/Cattura-1.png\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/Cattura-1.png 647w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/Cattura-1-300x90.png 300w\" sizes=\"auto, (max-width: 647px) 100vw, 647px\" width=\"647\" height=\"194\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"limiti-e-svantaggi-b95a7e18-16df-45f4-a914-5ebf14c7674d\"><span class=\"ez-toc-section\" id=\"Limiti_e_svantaggi\"><\/span>Limiti e svantaggi<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>possibili <strong>falsi positivi<\/strong>, anche in infezioni precoci;<\/li>\n\n\n\n<li><strong>falsi negativi<\/strong> osservati in EI causata da alcuni microrganismi;<\/li>\n\n\n\n<li>limitazioni nelle infezioni da CIED, soprattutto in presenza di vegetazioni molto piccole sui cateteri;<\/li>\n\n\n\n<li>necessit\u00e0 di manipolazione del sangue per preparare il radiofarmaco;<\/li>\n\n\n\n<li>procedura pi\u00f9 lunga rispetto alla PET\/CT;<\/li>\n\n\n\n<li>risoluzione spaziale e efficienza di rilevazione dei fotoni <strong>inferiori<\/strong> alla PET\/CT.<\/li>\n<\/ul>\n\n\n\n<p>La scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO non ha praticamente alcun ruolo nella diagnosi della <strong>spondilodiscite<\/strong>. Infatti, sia i corpi vertebrali che i dischi intervertebrali sono contenuti in strutture praticamente non espandibili; di conseguenza, gli eventi patologici che generano edema locale aumentano la pressione interstiziale, impedendo un accumulo efficace dei leucociti marcati nel sito di infezione o infiammazione durante la finestra temporale utile per l\u2019imaging.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"risultati-e-osservazioni-526ee50e-7c4a-4ffa-bd4b-d68346fb41b1\"><span class=\"ez-toc-section\" id=\"Risultati_e_osservazioni\"><\/span>Risultati e osservazioni<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>La <strong>sensibilit\u00e0 <\/strong>della SPECT\/CT con leucociti marcati con <sup>99m<\/sup>Tc-HMPAO nella diagnosi di <strong><span style=\"text-decoration: underline;\">endocardite su valvola protesica<\/span><\/strong> (<strong>PVE<\/strong>) varia complessivamente tra il 64% e il 90%, con una <strong>specificit\u00e0 <\/strong>tra il 36% e il 100%. I <strong>valori predittivi positivi <\/strong>vanno dall\u201985% al 100%, mentre quelli <strong>negativi <\/strong>tra il 47% e l\u201981%. In presenza di <strong>ascessi<\/strong>, la <strong>sensibilit\u00e0 <\/strong>aumenta ulteriormente (83\u2013100%), cos\u00ec come la <strong>specificit\u00e0 <\/strong>(78\u201387%), con una notevole affidabilit\u00e0 soprattutto nella fase precoce post-intervento.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-full is-resized\"><a href=\"https:\/\/amzn.to\/3Ix0j4f\"><img loading=\"lazy\" decoding=\"async\" width=\"309\" height=\"425\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/image-8.png\" alt=\"\" class=\"wp-image-24626\" style=\"width:169px;height:auto\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/image-8.png 309w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/image-8-218x300.png 218w\" sizes=\"auto, (max-width: 309px) 100vw, 309px\" \/><\/a><figcaption class=\"wp-element-caption\"><a href=\"https:\/\/amzn.to\/3Ix0j4f\"><strong>Acquista<\/strong><\/a><\/figcaption><\/figure>\n<\/div>\n\n\n<p>Analogamente, le tecniche di imaging con <sup>99m<\/sup>Tc-HMPAO-WBC SPECT\/CT \u00e8  fondamentale per confermare o escludere l\u2019<strong><span style=\"text-decoration: underline;\">infezione associata ai dispositivi cardiaci impiantabili<\/span><\/strong> (<strong>CIED<\/strong>), consentendo anche una valutazione dell\u2019estensione del processo infettivo, inclusa quella extracardiaca. Lo studio pi\u00f9 ampio condotto con scintigrafia <sup>99m<\/sup>Tc-HMPAO-WBC ha riportato una sensibilit\u00e0 del <strong>94% <\/strong>e una specificit\u00e0 del <strong>100%<\/strong>.<br>La precisione diagnostica \u00e8 pi\u00f9 bassa per le infezioni dei cateteri (<strong><em>lead<\/em><\/strong>), con una sensibilit\u00e0 aggregata del 65% e una specificit\u00e0 dell\u201988%. Questa limitazione \u00e8 attribuibile principalmente alle dimensioni ridotte delle vegetazioni che si formano lungo i fili conduttori, spesso al di sotto della risoluzione spaziale dei sistemi di imaging.<\/p>\n\n\n\n<p>Per quanto riguarda le infezioni\/infiammazioni ossee, l\u2019accuratezza diagnostica della scintigrafia con <sup>99m<\/sup>Tc-HMPAO-WBC \u00e8 superiore al <strong>95%<\/strong>.<\/p>\n\n\n\n<p>In caso di <strong>alta probabilit\u00e0<\/strong> di infezione, basata su fattori come frattura, chirurgia recente, osteosintesi o esami sierologici fortemente positivi, \u00e8 raccomandata la scintigrafia con <strong>leucociti autologhi marcati<\/strong>, per la sua elevata specificit\u00e0 e capacit\u00e0 di localizzazione.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-large is-resized\"><a href=\"https:\/\/amzn.to\/4aTddDr\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"817\" height=\"1024\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/610uHTJ76qL._SL1036_-817x1024.jpg\" alt=\"\" class=\"wp-image-18269\" style=\"width:165px;height:auto\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/610uHTJ76qL._SL1036_-817x1024.jpg 817w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/610uHTJ76qL._SL1036_-239x300.jpg 239w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/610uHTJ76qL._SL1036_-768x962.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/610uHTJ76qL._SL1036_.jpg 827w\" sizes=\"auto, (max-width: 817px) 100vw, 817px\" \/><\/a><figcaption class=\"wp-element-caption\"><strong><a href=\"https:\/\/amzn.to\/4aTddDr\" target=\"_blank\" rel=\"noreferrer noopener\">Acquista ora<\/a><\/strong><\/figcaption><\/figure>\n<\/div>\n\n\n<p>Al contrario, in pazienti con <strong>bassa probabilit\u00e0 pre-test<\/strong>, si raccomanda di eseguire <strong>prima la scintigrafia ossea trifasica<\/strong>, grazie alla sua alta sensibilit\u00e0 e valore predittivo negativo. Se questa risulta positiva, si procede con imaging mediante leucociti autologhi o anticorpi anti-granulociti, utilizzando sia immagini planari che SPECT\/CT.<\/p>\n\n\n\n<p>Quando la scintigrafia con leucociti (o con anticorpi anti-granulociti) risulta <strong>negativa<\/strong>, l\u2019esame conclusivo per distinguere infezione da infiammazione \u00e8 la <strong>PET\/CT con [<sup>18<\/sup>F]FDG<\/strong>. Quest\u2019ultima viene anche consigliata <strong>come prima metodica di imaging<\/strong> nei pazienti con alta sospetta disseminazione ematogena dell\u2019infezione.<\/p>\n\n\n<div id=\"bmscience2789740511\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/40p5aup\" target=\"_blank\" aria-label=\"61YY6aokQXL._SX3000_\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/61YY6aokQXL._SX3000_-scaled.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/61YY6aokQXL._SX3000_-scaled.jpg 2560w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/61YY6aokQXL._SX3000_-300x71.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/61YY6aokQXL._SX3000_-1024x241.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/61YY6aokQXL._SX3000_-768x181.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/61YY6aokQXL._SX3000_-1536x361.jpg 1536w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/61YY6aokQXL._SX3000_-2048x482.jpg 2048w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" width=\"2560\" height=\"602\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n\n<h2 class=\"wp-block-heading\" id=\"casi-clinici-aa8a32dd-79aa-4645-96c7-4f5330c410fd\"><span class=\"ez-toc-section\" id=\"Casi_clinici\"><\/span>Casi clinici<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<div class=\"wp-block-advgb-adv-tabs advgb-tabs-wrapper advgb-tab-horz-desktop advgb-tab-vert-tablet advgb-tab-stack-mobile advgb-tabs-e72e8434-b591-41b3-aeb7-d32542fca2b8\" data-tab-active=\"0\"><ul class=\"advgb-tabs-panel\" role=\"tablist\"><li class=\"advgb-tab advgb-tab-active\" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_c972a8-13-0\" aria-controls=\"advgb-tab-panel-_c972a8-13-0\" role=\"tab\" aria-selected=\"true\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Mobilizzazione protesi<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_c972a8-13-1\" aria-controls=\"advgb-tab-panel-_c972a8-13-1\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Infezione protesi<\/strong><\/span><\/button><\/li><\/ul><div class=\"advgb-tab-body-wrapper\" style=\"border-style:solid;border-width:1px;border-radius:10px\">\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_c972a8-13-0\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_c972a8-13-0\" tabindex=\"0\"><span><strong>Mobilizzazione protesi<\/strong><\/span><\/div><div class=\"advgb-tab-_c972a8-13 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_c972a8-13-0\" style=\"display:none\">\n<p><strong>Scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO in un paziente con sospetto allentamento asettico della protesi di caviglia destra<\/strong>.<\/p>\n\n\n\n<p>La paziente, sottoposta a impianto protesico tre anni prima per frattura trimalleolare, presentava dolore, tumefazione, limitazione funzionale e febbre intermittente, ma con indici infiammatori (VES e PCR) nei limiti.<\/p>\n\n\n\n<p>La scintigrafia ossea trifasica con <sup>99m<\/sup>Tc-HDP ha mostrato captazione aumentata in tutte le fasi (di perfusione, \u201cblood pool\u201d e tardiva) indicativa di i<strong>nfiammazione periprotesica<\/strong>.<\/p>\n\n\n\n<div class=\"wp-block-advgb-accordions advgb-accordions-0a922980-50bf-4b31-a778-d207972b3bfe advgb-accordion-wrapper\" data-collapsed=\"true\">\n<div class=\"wp-block-advgb-accordion-item advgb-accordion-item\" style=\"margin-bottom:15px\"><div class=\"advgb-accordion-header\" style=\"background-color:#000;color:#eee;border-style:solid;border-width:1px;border-radius:2px\"><span class=\"advgb-accordion-header-icon accordion-state\"><svg class=\"advgb-icon-closed\" fill=\"#fff\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\"><path fill=\"none\" d=\"M0,0h24v24H0V0z\"><\/path><path d=\"M12,2C6.48,2,2,6.48,2,12s4.48,10,10,10s10-4.48,10-10S17.52,2,12,2z M17,13h-4v4h-2v-4H7v-2h4V7h2v4h4V13z\"><\/path><\/svg><svg class=\"advgb-icon-opened\" fill=\"#fff\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\"><path fill=\"none\" d=\"M0,0h24v24H0V0z\"><\/path><path d=\"M12,2C6.48,2,2,6.48,2,12s4.48,10,10,10s10-4.48,10-10S17.52,2,12,2z M17,13H7v-2h10V13z\"><\/path><\/svg><\/span><h4 class=\"advgb-accordion-header-title\" style=\"color:inherit\">Scintigrafia trifasica<\/h4><\/div><div class=\"advgb-accordion-body\" style=\"border-style:solid !important;border-width:1px !important;border-color:undefined !important;border-top:none !important;border-radius:2px !important\">\n<div class=\"wp-block-advgb-adv-tabs advgb-tabs-wrapper advgb-tab-horz-desktop advgb-tab-vert-tablet advgb-tab-stack-mobile advgb-tabs-372d1945-1353-40af-a5c5-81edffc7176a\" data-tab-active=\"0\"><ul class=\"advgb-tabs-panel\" role=\"tablist\"><li class=\"advgb-tab advgb-tab-active\" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_373859-b0-0\" aria-controls=\"advgb-tab-panel-_373859-b0-0\" role=\"tab\" aria-selected=\"true\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Fase di perfusione<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_373859-b0-1\" aria-controls=\"advgb-tab-panel-_373859-b0-1\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Fase &#8220;blood pool<\/strong>&#8220;<strong> e tardiva<\/strong><\/span><\/button><\/li><\/ul><div class=\"advgb-tab-body-wrapper\" style=\"border-style:solid;border-width:1px;border-radius:10px\">\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_373859-b0-0\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_373859-b0-0\" tabindex=\"0\"><span><strong>Fase di perfusione<\/strong><\/span><\/div><div class=\"advgb-tab-_373859-b0 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_373859-b0-0\" style=\"display:none\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471c01d&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471c01d\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"738\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.1-1024x738.jpg\" alt=\"\" class=\"wp-image-24594\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.1-1024x738.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.1-300x216.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.1-768x554.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.1.jpg 1028w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<pre class=\"wp-block-verse\">La <strong>fase di perfusione <\/strong>della scintigrafia ossea trifasica con <sup>99m<\/sup>Tc-HDP mostra una captazione aumentata del tracciante a livello della caviglia destra.<br>Le immagini planari in proiezione anteriore (pannello sinistro) e posteriore (pannello destro) evidenziano un iperafflusso locale compatibile con processo infiammatorio in corso.<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- header-active\" id=\"advgb-tab-panel-_373859-b0-1\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_373859-b0-1\" tabindex=\"0\"><span><strong>Fase &#8220;blood pool<\/strong>&#8220;<strong> e tardiva<\/strong><\/span><\/div><div class=\"advgb-tab-_373859-b0 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_373859-b0-1\" style=\"display:block\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471c427&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471c427\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"529\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.2-2-1024x529.jpg\" alt=\"\" class=\"wp-image-24604\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.2-2-1024x529.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.2-2-300x155.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.2-2-768x397.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.2-2.jpg 1028w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<pre class=\"wp-block-verse\">La<strong> fase \u201c<em>blood pool<\/em>\u201d <\/strong>(riga superiore) e la <strong>fase tardiva <\/strong>(riga inferiore) della scintigrafia ossea con <sup>99m<\/sup>Tc-HDP mostrano una captazione aumentata del tracciante nei tessuti molli peri-protesici e nelle strutture ossee della caviglia destra, reperti suggestivi di infiammazione attiva in sede periprotesica.<\/pre>\n<\/div><\/div>\n<\/div><\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<p>Per chiarire la natura del processo infiammatorio, \u00e8 stata eseguita una scintigrafia con <sup>99m<\/sup>Tc-HMPAO-WBC, che ha evidenziato inizialmente accumulo diffuso nei tessuti molli periprotesici, con progressiva riduzione della captazione nelle immagini a 3 e 20 ore.<\/p>\n\n\n\n<div class=\"wp-block-advgb-accordions advgb-accordions-810d5c78-264e-4616-8632-4872aad1f5c7 advgb-accordion-wrapper\" data-collapsed=\"true\">\n<div class=\"wp-block-advgb-accordion-item advgb-accordion-item\" style=\"margin-bottom:15px\"><div class=\"advgb-accordion-header\" style=\"background-color:#000;color:#eee;border-style:solid;border-width:1px;border-radius:2px\"><span class=\"advgb-accordion-header-icon accordion-state\"><svg class=\"advgb-icon-closed\" fill=\"#fff\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\"><path fill=\"none\" d=\"M0,0h24v24H0V0z\"><\/path><path d=\"M12,2C6.48,2,2,6.48,2,12s4.48,10,10,10s10-4.48,10-10S17.52,2,12,2z M17,13h-4v4h-2v-4H7v-2h4V7h2v4h4V13z\"><\/path><\/svg><svg class=\"advgb-icon-opened\" fill=\"#fff\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\"><path fill=\"none\" d=\"M0,0h24v24H0V0z\"><\/path><path d=\"M12,2C6.48,2,2,6.48,2,12s4.48,10,10,10s10-4.48,10-10S17.52,2,12,2z M17,13H7v-2h10V13z\"><\/path><\/svg><\/span><h4 class=\"advgb-accordion-header-title\" style=\"color:inherit\">Scintigrafia con leucociti marcati<\/h4><\/div><div class=\"advgb-accordion-body\" style=\"border-style:solid !important;border-width:1px !important;border-color:undefined !important;border-top:none !important;border-radius:2px !important\">\n<div class=\"wp-block-advgb-adv-tabs advgb-tabs-wrapper advgb-tab-horz-desktop advgb-tab-vert-tablet advgb-tab-stack-mobile advgb-tabs-822cffd6-ac23-45a1-8b0d-88b0dd4e59e1\" data-tab-active=\"0\"><ul class=\"advgb-tabs-panel\" role=\"tablist\"><li class=\"advgb-tab advgb-tab-active\" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_9a4800-df-0\" aria-controls=\"advgb-tab-panel-_9a4800-df-0\" role=\"tab\" aria-selected=\"true\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Immagini planari<\/strong><\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_9a4800-df-1\" aria-controls=\"advgb-tab-panel-_9a4800-df-1\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span><strong>Immagini assiali, sagittali e coronali<\/strong><\/span><\/button><\/li><\/ul><div class=\"advgb-tab-body-wrapper\" style=\"border-style:solid;border-width:1px;border-radius:10px\">\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_9a4800-df-0\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_9a4800-df-0\" tabindex=\"0\"><span><strong>Immagini planari<\/strong><\/span><\/div><div class=\"advgb-tab-_9a4800-df advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_9a4800-df-0\" style=\"display:none\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471c93f&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471c93f\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"777\" height=\"1024\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.3-777x1024.jpg\" alt=\"\" class=\"wp-image-24612\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.3-777x1024.jpg 777w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.3-228x300.jpg 228w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.3-768x1012.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.3.jpg 1028w\" sizes=\"auto, (max-width: 777px) 100vw, 777px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<pre class=\"wp-block-verse\">Le immagini planari acquisite a 30 minuti (a sinistra), 3 ore (al centro) e 20 ore (a destra) mostrano un accumulo diffuso di <strong>leucociti marcati con <sup>99m<\/sup>Tc-HMPAO<\/strong> nella caviglia destra, con un\u2019intensit\u00e0 che diminuisce progressivamente nel tempo. Questo andamento \u00e8 indicativo di un processo infiammatorio asettico, senza evidenza di infezione attiva.<\/pre>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- header-active\" id=\"advgb-tab-panel-_9a4800-df-1\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_9a4800-df-1\" tabindex=\"0\"><span><strong>Immagini assiali, sagittali e coronali<\/strong><\/span><\/div><div class=\"advgb-tab-_9a4800-df advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_9a4800-df-1\" style=\"display:block\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:60%\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471cf32&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471cf32\" class=\"wp-block-image alignwide size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"696\" height=\"703\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.4.jpg\" alt=\"\" class=\"wp-image-24613\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.4.jpg 696w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-1.4-297x300.jpg 297w\" sizes=\"auto, (max-width: 696px) 100vw, 696px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\">\n<p>Le immagini assiali (sinistra), sagittali (centro) e coronali (destra) acquisite 3 ore dopo l\u2019infusione di leucociti marcati con <sup>99m<\/sup>Tc-HMPAO mostrano un accumulo moderato e diffuso nei tessuti molli peri-protesici. Le sezioni superiori mostrano immagini SPECT\/CT fuse, quelle centrali solo SPECT, e quelle inferiori la TC a bassa dose.<\/p>\n<\/div>\n<\/div>\n\n\n\n<p>Il pattern di captazione \u00e8 indicativo di un\u2019infiammazione asettica persistente intorno alla protesi della caviglia.<\/p>\n<\/div><\/div>\n<\/div><\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<p>Il quadro \u00e8 compatibile con un <strong>processo infiammatorio asettico<\/strong>, verosimilmente correlato a complicanza post-chirurgica.<\/p>\n\n\n\n<pre class=\"wp-block-verse\">La scintigrafia ossea trifasica con<sup> 99m<\/sup>Tc-HDP rappresenta uno strumento utile per la valutazione preliminare di pazienti con dolore articolare in sede protesica, permettendo di distinguere tra <strong>mobilizzazione asettica <\/strong>e <strong>infiammazione<\/strong>. Se la scintigrafia \u00e8 positiva per infiammazione, l\u2019esecuzione di una scintigrafia con leucociti autologhi marcati con <sup>99m<\/sup>Tc-HMPAO pu\u00f2 fornire informazioni pi\u00f9 specifiche, in particolare per differenziare l\u2019infezione (caratterizzata da captazione progressivamente crescente fino a 20 ore) dall\u2019infiammazione asettica (che mostra captazione iniziale, eventualmente presente a 3 ore, ma con declino progressivo nel tempo).<br>Inoltre, nonostante possibili artefatti da protesi metalliche nelle immagini TC, l\u2019acquisizione SPECT\/CT pu\u00f2 aiutare a localizzare con precisione la sede della captazione dei leucociti radiomarcati: in particolare, a distinguere se l\u2019accumulo \u00e8 confinato ai tessuti molli peri-protesici, all\u2019osso oppure coinvolge entrambe le strutture. Questa differenziazione \u00e8 fondamentale per orientare la gestione clinica e terapeutica del paziente.<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- header-active\" id=\"advgb-tab-panel-_c972a8-13-1\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_c972a8-13-1\" tabindex=\"0\"><span><strong>Infezione protesi<\/strong><\/span><\/div><div class=\"advgb-tab-_c972a8-13 advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_c972a8-13-1\" style=\"display:block\">\n<p><strong>Scintigrafia con leucociti marcati <sup>99m<\/sup>Tc-HMPAO in una paziente di 64 anni con gonartrosi severa<\/strong> al ginocchio destro, dolore, tumefazione e limitazione funzionale. Quattro anni prima era stata trattata con antibiotici ad alte dosi per positivit\u00e0 del liquido sinoviale a <em>Staphylococcus epidermidis<\/em>. In seguito all\u2019aumento degli indici infiammatori (VES e PCR), \u00e8 stata richiesta la scintigrafia con <sup>99m<\/sup>Tc-HMPAO-WBC per escludere un&#8217;infezione prima dell\u2019impianto protesico.<\/p>\n\n\n\n<div class=\"wp-block-advgb-accordions advgb-accordions-d1fbdccf-9213-4456-a839-a9a660edc967 advgb-accordion-wrapper\" data-collapsed=\"true\">\n<div class=\"wp-block-advgb-accordion-item advgb-accordion-item\" style=\"margin-bottom:15px\"><div class=\"advgb-accordion-header\" style=\"background-color:#000;color:#eee;border-style:solid;border-width:1px;border-radius:2px\"><span class=\"advgb-accordion-header-icon accordion-state\"><svg class=\"advgb-icon-closed\" fill=\"#fff\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\"><path fill=\"none\" d=\"M0,0h24v24H0V0z\"><\/path><path d=\"M12,2C6.48,2,2,6.48,2,12s4.48,10,10,10s10-4.48,10-10S17.52,2,12,2z M17,13h-4v4h-2v-4H7v-2h4V7h2v4h4V13z\"><\/path><\/svg><svg class=\"advgb-icon-opened\" fill=\"#fff\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\"><path fill=\"none\" d=\"M0,0h24v24H0V0z\"><\/path><path d=\"M12,2C6.48,2,2,6.48,2,12s4.48,10,10,10s10-4.48,10-10S17.52,2,12,2z M17,13H7v-2h10V13z\"><\/path><\/svg><\/span><h4 class=\"advgb-accordion-header-title\" style=\"color:inherit\">Scintigrafia con leucociti marcati <\/h4><\/div><div class=\"advgb-accordion-body\" style=\"border-style:solid !important;border-width:1px !important;border-color:undefined !important;border-top:none !important;border-radius:2px !important\">\n<div class=\"wp-block-advgb-adv-tabs advgb-tabs-wrapper advgb-tab-horz-desktop advgb-tab-vert-tablet advgb-tab-stack-mobile advgb-tabs-aa7d87dd-60d1-4f2d-bcc0-5d53a8f2fa81\" data-tab-active=\"0\"><ul class=\"advgb-tabs-panel\" role=\"tablist\"><li class=\"advgb-tab advgb-tab-active\" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_72f220-cd-0\" aria-controls=\"advgb-tab-panel-_72f220-cd-0\" role=\"tab\" aria-selected=\"true\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span>Planari anteriori e posteriori<\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_72f220-cd-1\" aria-controls=\"advgb-tab-panel-_72f220-cd-1\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span>Planari mediali e laterali<\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_72f220-cd-2\" aria-controls=\"advgb-tab-panel-_72f220-cd-2\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span>SPECT\/CT fuse assiale, sagittale e coronale<\/span><\/button><\/li><li class=\"advgb-tab \" role=\"presentation\" style=\"background-color:#e0e0e0;border-style:solid;border-width:1px;border-radius:10px\"><button class=\"advgb-tab-button\" id=\"advgb-tab-_72f220-cd-3\" aria-controls=\"advgb-tab-panel-_72f220-cd-3\" role=\"tab\" aria-selected=\"false\" tabindex=\"0\" style=\"color:#fff;background:none;border:none;width:100%;text-align:inherit;cursor:pointer;padding:8px 16px;font:inherit\"><span>SPECT\/CT fuse assiale, sagittale e coronale<\/span><\/button><\/li><\/ul><div class=\"advgb-tab-body-wrapper\" style=\"border-style:solid;border-width:1px;border-radius:10px\">\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_72f220-cd-0\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_72f220-cd-0\" tabindex=\"0\"><span>Planari anteriori e posteriori<\/span><\/div><div class=\"advgb-tab-_72f220-cd advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_72f220-cd-0\" style=\"display:none\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471d64e&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471d64e\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"691\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.1-1024x691.jpg\" alt=\"\" class=\"wp-image-24590\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.1-1024x691.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.1-300x203.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.1-768x518.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.1.jpg 1028w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<pre class=\"wp-block-verse\">Le immagini planari anteriori (riga superiore) e posteriori (riga inferiore) acquisite a 30 minuti, 3 ore e 20 ore dopo l\u2019infusione di leucociti marcati con <sup>99m<\/sup>Tc-HMPAO mostrano un accumulo diffuso e progressivamente crescente di radioattivit\u00e0 nel ginocchio destro.<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_72f220-cd-1\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_72f220-cd-1\" tabindex=\"0\"><span>Planari mediali e laterali<\/span><\/div><div class=\"advgb-tab-_72f220-cd advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_72f220-cd-1\" style=\"display:none\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471da2d&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471da2d\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"717\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.2-1024x717.jpg\" alt=\"\" class=\"wp-image-24591\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.2-1024x717.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.2-300x210.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.2-768x538.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.2.jpg 1028w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<pre class=\"wp-block-verse\">Le immagini planari mediali (riga superiore) e laterali (riga inferiore) acquisite a 30 minuti, 3 ore e 20 ore dopo l\u2019infusione di leucociti marcati con <sup>99m<\/sup>Tc-HMPAO mostrano un accumulo diffuso nel ginocchio destro, con intensit\u00e0 e distribuzione che aumentano progressivamente nel tempo<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- \" id=\"advgb-tab-panel-_72f220-cd-2\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_72f220-cd-2\" tabindex=\"0\"><span>SPECT\/CT fuse assiale, sagittale e coronale<\/span><\/div><div class=\"advgb-tab-_72f220-cd advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_72f220-cd-2\" style=\"display:none\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471de4e&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471de4e\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"619\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.3-1024x619.jpg\" alt=\"\" class=\"wp-image-24592\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.3-1024x619.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.3-300x181.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.3-768x464.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.3.jpg 1028w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<pre class=\"wp-block-verse\">Le immagini SPECT\/CT fuse in proiezioni assiale (sinistra), sagittale (centro) e coronale (destra), acquisite a 3 ore (riga superiore) e 20 ore (riga inferiore) dopo l\u2019infusione di leucociti marcati con <sup>99m<\/sup>Tc-HMPAO, mostrano un accumulo diffuso e progressivamente crescente di radioattivit\u00e0 in corrispondenza di versamento peri- e intra-articolare del ginocchio destro.<\/pre>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-advgb-tab advgb-tab-body-container\"><div class=\"advgb-tab-body-header advgb-tab-class- header-active\" id=\"advgb-tab-panel-_72f220-cd-3\" role=\"tabpanel\" aria-labelledby=\"advgb-tab-_72f220-cd-3\" tabindex=\"0\"><span>SPECT\/CT fuse assiale, sagittale e coronale<\/span><\/div><div class=\"advgb-tab-_72f220-cd advgb-tab-body\" aria-labelledby=\"advgb-tab-panel-_72f220-cd-3\" style=\"display:block\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69ee35471e222&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69ee35471e222\" class=\"wp-block-image alignwide size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"619\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.4-1024x619.jpg\" alt=\"\" class=\"wp-image-24593\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.4-1024x619.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.4-300x181.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.4-768x464.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/caso-2.4.jpg 1028w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Ingrandisci\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<pre class=\"wp-block-verse\">Le immagini SPECT\/CT fuse in proiezioni assiale (sinistra), sagittale (centro) e coronale (destra), acquisite a 3 ore (riga superiore) e 20 ore (riga inferiore) dopo l\u2019infusione di leucociti marcati con <sup>99m<\/sup>Tc-HMPAO, mostrano un accumulo moderato e diffuso nel femore distale e nella tibia prossimale destra. Il pattern temporale evidenzia una diminuzione progressiva della captazione.<\/pre>\n<\/div><\/div>\n<\/div><\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<p>Le immagini planari acquisite a 30 minuti, 3 ore e 20 ore dopo l\u2019infusione del radiofarmaco mostrano un\u2019intensa captazione al ginocchio destro, con incremento progressivo nel tempo. L\u2019acquisizione SPECT\/CT ha permesso di distinguere due focolai:<\/p>\n\n\n\n<ol start=\"1\" class=\"wp-block-list\">\n<li>uno con <strong>trend crescente nel tempo<\/strong>, localizzato in un\u2019area di versamento peri- e intra-articolare, compatibile con <strong>artrosinovite settica<\/strong>;<\/li>\n\n\n\n<li>uno con <strong>captazione pi\u00f9 evidente a 3 ore e decrescente a 20 ore<\/strong>, localizzato nel <strong>femore distale e nella tibia prossimale destra<\/strong>, suggestivo di <strong>infiammazione asettica<\/strong> associata a gonartrosi.<\/li>\n<\/ol>\n\n\n\n<p>La scintigrafia con <sup>99m<\/sup>Tc-HMPAO-WBC offre un\u2019elevata specificit\u00e0 per distinguere:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>infezione<\/strong>: captazione che aumenta e si estende nel tempo;<\/li>\n\n\n\n<li><strong>infiammazione asettica<\/strong>: captazione iniziale che pu\u00f2 aumentare fino a 3\u20134 ore, ma tende poi a diminuire.<\/li>\n<\/ul>\n\n\n\n<p>Le immagini SPECT\/CT sono particolarmente utili per localizzare il processo infiammatorio\/infiammatorio e identificarne la distribuzione tra tessuti molli e strutture ossee.<\/p>\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p><em>Fonte:&nbsp;<\/em><a href=\"https:\/\/www.amazon.it\/gp\/search?ie=UTF8&amp;tag=bmscience.net-21&amp;linkCode=ur2&amp;linkId=26836e739cfede8ee8de1cdbb724998c&amp;camp=3414&amp;creative=21718&amp;index=books&amp;keywords=Fondamenti%20di%20medicina%20nucleare.%20Tecniche%20e%20applicazioni\" target=\"_blank\" rel=\"noreferrer noopener\">Fondamenti di medicina nucleare. Tecniche e applicazioni.<\/a><\/p>\n<\/blockquote>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Altre fonti: <a href=\"https:\/\/amzn.to\/3U7PXdA\">Atlas of Clinical Nuclear Medicine<\/a>.<\/p>\n<\/blockquote>\n\n\n<div id=\"bmscience443669711\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/4k1fShA\" target=\"_blank\" aria-label=\"2f38a0b9-3bd0-43d0-aea0-c05a33332c2e._CR0,0,3000,600_SX1920_\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/2f38a0b9-3bd0-43d0-aea0-c05a33332c2e._CR003000600_SX1920_.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/2f38a0b9-3bd0-43d0-aea0-c05a33332c2e._CR003000600_SX1920_.jpg 1920w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/2f38a0b9-3bd0-43d0-aea0-c05a33332c2e._CR003000600_SX1920_-300x60.jpg 300w, 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href=\"https:\/\/bmscience.net\/blog\/scintigrafia-con-leucociti-autologhi-marcati-con-99mtc-hmpao\/\">Continue reading <span class=\"screen-reader-text\">Scintigrafia con leucociti autologhi marcati con 99mTc-HMPAO<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":24615,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","footnotes":""},"categories":[70,7],"tags":[10168,10156,778,10165,10160,10170,8867,10167,3905,10169,5443,5697,8699,6620],"class_list":["post-24577","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-malattie-infettive","category-medicina-nucleare","tag-111in-oxina","tag-99mtc-hmpao","tag-ascesso","tag-cied","tag-endocardite","tag-focolai-infettivi","tag-fuo","tag-hmpao","tag-infezione","tag-leucociti-autologhi","tag-osteomielite","tag-piede-diabetico","tag-scintigrafia","tag-scintigrafia-ossea","entry"],"author_meta":{"display_name":"Raffo Coco","author_link":"https:\/\/bmscience.net\/blog\/author\/raffo\/"},"featured_img":"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/07\/leucociti-300x253.jpg","coauthors":[],"tax_additional":{"categories":{"linked":["<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/malattie-infettive\/\" class=\"advgb-post-tax-term\">Malattie infettive<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">Medicina Nucleare<\/a>"],"unlinked":["<span class=\"advgb-post-tax-term\">Malattie infettive<\/span>","<span class=\"advgb-post-tax-term\">Medicina Nucleare<\/span>"]},"tags":{"linked":["<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">111In-oxina<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">99mTc-HMPAO<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">ascesso<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">CIED<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">endocardite<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">focolai infettivi<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">FUO<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">HMPAO<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">Infezione<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">leucociti autologhi<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">osteomielite<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">piede diabetico<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">scintigrafia<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/medicina-nucleare\/\" class=\"advgb-post-tax-term\">Scintigrafia Ossea<\/a>"],"unlinked":["<span class=\"advgb-post-tax-term\">111In-oxina<\/span>","<span class=\"advgb-post-tax-term\">99mTc-HMPAO<\/span>","<span class=\"advgb-post-tax-term\">ascesso<\/span>","<span class=\"advgb-post-tax-term\">CIED<\/span>","<span class=\"advgb-post-tax-term\">endocardite<\/span>","<span class=\"advgb-post-tax-term\">focolai infettivi<\/span>","<span class=\"advgb-post-tax-term\">FUO<\/span>","<span class=\"advgb-post-tax-term\">HMPAO<\/span>","<span class=\"advgb-post-tax-term\">Infezione<\/span>","<span class=\"advgb-post-tax-term\">leucociti autologhi<\/span>","<span class=\"advgb-post-tax-term\">osteomielite<\/span>","<span class=\"advgb-post-tax-term\">piede diabetico<\/span>","<span class=\"advgb-post-tax-term\">scintigrafia<\/span>","<span class=\"advgb-post-tax-term\">Scintigrafia Ossea<\/span>"]}},"comment_count":"0","relative_dates":{"created":"Pubblicato 9 mesi fa","modified":"Aggiornato 9 mesi fa"},"absolute_dates":{"created":"Pubblicato il 21\/07\/2025","modified":"Aggiornato il 27\/07\/2025"},"absolute_dates_time":{"created":"Pubblicato il 21\/07\/2025 10:21","modified":"Aggiornato il 27\/07\/2025 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