Are 99mTc leukocyte scintigraphy and SBFT studies useful in children suspected of having inflammatory bowel disease?
OBJECTIVE
The goal of this retrospective study was to assess whether 99mTc-white blood cell (WBC) scintigraphy and upper gastrointestinal small bowel follow-through (UGI-SBFT) could exclude inflammation in children suspected of having inflammatory bowel disease (IBD).


METHODS
Of a population of 313 children who had a 99mTc-WBC scan, 130 children were studied exclusively to rule out IBD. Sixty-nine colonoscopies with biopsies were done within a short time interval of the 99mTc-WBC scans. There were also 51 controls studied with 99mTc-WBC scintigraphy.


RESULTS
Of the 130 children studied to exclude IBD, the final diagnosis was Crohn's disease in 27, ulcerative colitis in nine, miscellaneous colitis in 13, probably normal in 42, and normal in 39. The 99mTc-WBC scans were positive in all but three newly diagnosed Crohn's disease, ulcerative colitis, or miscellaneous colitis children. The false-negative 99mTc-WBC studies were seen in children with mild inflammation on biopsies and normal UGI-SBFT studies. In the 46 children with a true-positive 99mTc-WBC scan, 81% (17/21) of UGI-SBFT studies were normal. In five children with equivocal UGI-SBFT studies, the 99mTc-WBC scan correctly predicted if inflammation was present in the terminal ileum.


CONCLUSIONS
Our results suggest that 99mTc-WBC is useful as an initial screening modality to exclude IBD, and is more sensitive than UGI-SBFT studies.
Charron
M
M
Department of Radiology, Children's Hospital of Pittsburgh, and University of Pittsburgh School of Medicine, Pennsylvania, USA.
Di Lorenzo
C
C
Kocoshis
S
S
D000293:Adolescent; D002648:Child; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging; D003113:Colonoscopy; D003424:Crohn Disease / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D007422:Intestines / Q000000981:diagnostic imaging*; D007962:Leukocytes; D008297:Male; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013667:Technetium; D015899:Tomography, Emission-Computed, Single-Photon
D013667:Technetium