Technetium-99m HMPAO-labeled leukocyte imaging compared with endoscopy, ultrasonography, and contrast radiology in children with inflammatory bowel disease.
BACKGROUND
The purpose of this study was to evaluate retrospectively the value of leukocyte-labeled scintigraphy, ultrasonography, and contrast radiography compared with endoscopy in children suspected of having inflammatory bowel disease (IBD).


METHODS
Twenty-eight children (17 boys; mean age, 10.2 years) with IBD based on standard colonoscopic, histologic, and radiologic criteria (16 with Crohn's disease, 5 with ulcerative colitis, 5 with nonspecific colitis, I with granulomatous disease, and I with Beh,cet's disease) were included. Endoscopic, ultrasonographic, and contrast radiologic examinations were realized for 28, 23, and 19 children respectively.


RESULTS
Sensitivity and specificity were 75% and 92% for leukocyte-labeled scintigraphy, 39% and 90% for ultrasonography, and 58% and 83% for contrast radiography. The authors noted discontinuous uptake for 14 of 15 true-positive results for patients with Crohn's disease and continuous uptake for 4 of 4 true-positive results for patients with ulcerative colitis. A negative correlation between scan activity index and Lloyd-Still clinical score was found for 11 patients with Crohn's disease (r = -0.77).


CONCLUSIONS
Leukocyte-labeled scintigraphy, a noninvasive and reproducible technique, is a useful tool in the diagnosis and therapeutic strategy of IBD, and provides information on the presence, the intensity, and the extent of the disease, particularly in the terminal ileum. Leukocyte-labeled scintigraphy may not replace colonoscopy with biopsies for diagnosis confirmation. Its reliability seems higher than that of ultrasonography.
Alberini
J L
JL
Service de Médecine Nucléaire, Groupe Hospitalier Cochin-Saint Vincent de Paul, Paris, France. jean-louis.alberini@cch.ap-hop-paris.fr
Badran
A
A
Freneaux
E
E
Hadji
S
S
Kalifa
G
G
Devaux
J Y
JY
Dupont
T
T
D000293:Adolescent; D017609:Barium Compounds; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging; D003113:Colonoscopy; D003424:Crohn Disease / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007962:Leukocytes; D008297:Male; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime; D014463:Ultrasonography
D017609:Barium Compounds; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime