Detection of inflammatory bowel disease in pediatric patients with technetium-99m-HMPAO-labeled leukocytes.
Technetium-99m-HMPAO-labeled leukocyte imaging is now an accepted technique in the assessment of adult patients with inflammatory bowel disease (IBD), but its role in pediatric patients has not been studied.


METHODS
We evaluated the efficacy of 99mTc-HMPAO-labeled leukocyte imaging in 21 children. We studied 16 children with active IBD (4 ulcerative colitis, 10 Crohn's disease, 1 indeterminate colitis, 1 C-difficile) and 5 controls.


RESULTS
The sensitivity and specificity for active bowel inflammation were excellent. The intensity of uptake noted in most patients rendered image interpretation easy and straightforward. The inclusion of a tail on detector (TOD) view and anterior standing view of the abdomen is important. All patients with ulcerative colitis showed rectosigmoid disease and no small bowel activity, whereas, all patients with Crohn's disease showed discontinuous uptake and often small bowel activity. It was therefore possible to differentiate ulcerative colitis from Crohn's disease on the basis of location and distribution.


CONCLUSIONS
The 99mTc-HMPAO-labeled leukocyte scan is an excellent technique for the detection, localization and characterization of IBD in children.
Charron
M
M
Department of Radiology, Children's Hospital of Pittsburgh, PA 15213.
Orenstein
S R
SR
Bhargava
S
S
D002648:Child; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging*; D003106:Colon / Q000000981:diagnostic imaging; D003424:Crohn Disease / Q000000981:diagnostic imaging*; D005069:Evaluation Studies as Topic; D006801:Humans; D007962:Leukocytes; D015609:Organotechnetium Compounds; D010091:Oximes; D011877:Radionuclide Imaging; D012007:Rectum / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime; D014018:Tissue Distribution
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime