Investigating inflammatory bowel disease--white cell scanning, radiology, and colonoscopy.
OBJECTIVE
To evaluate different methods of examination of the bowel in suspected inflammatory bowel disease.


METHODS
Prospective investigation of all children over a three year period with suspected inflammatory bowel disease. A technetium-99m-HMPAO labelled white cell scan (Tc-WCS), barium follow through examination (Ba-FT), and colonoscopy plus biopsy were undertaken.


METHODS
Great Ormond Street Hospital for Children, London.


METHODS
39 children (20 male and 19 female), median age 12.1 years (range 3.9-15.1 years).


METHODS
There was total agreement in 21/39 cases, positive in 16, and negative in five. Of 31 histologically proved cases, positive results were obtained in 28 Tc-WCSs (sensitivity 90%), 10 of 24 Ba-FTs (sensitivity 42%), and 27 colonoscopies (sensitivity 87%).


CONCLUSIONS
The Tc-WCS is sensitive, specific, and non-invasive and should be a first line investigation. Ba-FT with a high radiation burden and relatively low sensitivity requires its role to be redefined. Colonoscopy, with endoscopic biopsy, has a high pick-up rate where facilities and expertise exist.
Jobling
J C
JC
Great Ormond Street Hospital for Children, NHS Trust, London.
Lindley
K J
KJ
Yousef
Y
Y
Gordon
I
I
Milla
P J
PJ
D000293:Adolescent; D001466:Barium Sulfate; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000175:diagnosis; D003113:Colonoscopy; D003424:Crohn Disease / Q000175:diagnosis; D005260:Female; D006098:Granulocytes / Q000000981:diagnostic imaging*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D015609:Organotechnetium Compounds; D010091:Oximes; D011446:Prospective Studies; D011859:Radiography; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime
D015609:Organotechnetium Compounds; D010091:Oximes; D001466:Barium Sulfate; D019690:Technetium Tc 99m Exametazime