99mTc-HMPAO leucocyte scintigraphy fails to detect Crohn's disease in the proximal gastrointestinal tract.
OBJECTIVE
To investigate the use of (99m)Tc-HMPAO (hexamethyl propylene amine oxime) leucocyte scintigraphy as a non-invasive screening test for inflammatory bowel disease.


METHODS
10 children with suspected Crohn's disease, in whom routine investigation using barium contrast radiology, upper gastrointestinal endoscopy, colonoscopy, and mucosal biopsies had identified severe gastroduodenal and/or jejunal involvement.


METHODS
(99m)Tc-HMPAO leucocyte scintigraphic studies performed in each of these cases were assessed by a radiologist who was blinded to the disease distribution.


RESULTS
In nine cases there was no scintigraphic evidence of inflammation in the proximal gastrointestinal tract. The 10th child had both gastroduodenal and jejunal involvement, but scintigraphy only revealed faint jejunal positivity.


CONCLUSIONS
(99m)Tc-HMPAO leucocyte scintigraphy should not be depended upon as a screening test for Crohn's disease. False negative results are likely in cases with Crohn's disease confined to the proximal gastrointestinal tract.
Davison
S M
SM
Department of Gastroenterology, Birmingham Children's Hospital and Institute of Child Health, University of Birmingham, Clinical Research Block, Whittall Street, Birmingham B4 6NH, UK.
Chapman
S
S
Murphy
M S
MS
D001466:Barium Sulfate; D001706:Biopsy; D002648:Child; D003287:Contrast Media; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D004382:Duodenitis / Q000000981:diagnostic imaging; D016099:Endoscopy, Gastrointestinal; D004751:Enteritis / Q000000981:diagnostic imaging; D005188:False Negative Reactions; D005756:Gastritis / Q000000981:diagnostic imaging*; D006801:Humans; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime
D003287:Contrast Media; D019275:Radiopharmaceuticals; D001466:Barium Sulfate; D019690:Technetium Tc 99m Exametazime