[99mTc-HMPAO-leukocyte-labeled scintigraphy in the detection and follow-up of inflammatory bowel disease].
To assess the clinical value of 99mTc-HMPAO-leukocyte-labeled scintigraphy (LLS) in the detection and follow-up of inflammatory bowel disease (IBD) in the pediatric population, we retrospectively reviewed 33 patients (15 boys; mean age 10.7 +/- 2.2 years) with suspected IBD. A total of 58 examinations were performed: 29 for screening purposes, 23 for follow-up and 6 to detect relapses. LLS was compared with clinical symptoms (PCDAI index), biologic markers of inflammation, barium contrast radiology (BCR; n = 22), sonography (n = 22), colonoscopy (n = 16), and biopsy (n = 13). The final diagnosis was Crohn's disease in 12, ulcerative colitis in 4, and no IBD in 17. In the 17 patients without IBD, LLS was always negative. Among the 16 patients with IBD, LLS showed concordant results with BCR in 7/10 patients, with sonography in 6/11, with colonoscopy in 9/12 and with biopsy in 8/9. The severity of LLS increased with the PCDAI index (p < 0.001), with a positive correlation between the scintigraphic activity index/PCDAI r = 0.76. An increase in the PCDAI index with the severity of LLS (p < 0.001) was also observed in the follow-up, and a weak correlation (r = 0.50) between erythrocyte sedimentation rate/scintigraphic activity index was obtained. In 5 patients with normal biologic markers, LLS detected inflammation. All 6 patients with relapses were symptomatic; 5 had inflammation on LLS and 5 had abnormal biologic markers. In conclusion, LLS can be a useful screening tool in the detection of IBD in children to assess the grade of inflammation and extension of IBD. This technique can detect the presence of inflammation during follow-up and should be performed when relapses are suspected.
Verdú Rico
J
J
Servicios de Medicina Nuclear, Hospital de San Juan de Alicante, España. verdu_jos@gva.es
Juste Ruiz
M
M
Jover
R
R
Muñoz Acosta
J
J
Muñoz
J
J
Martínez Caballero
A
A
Antón Leal
A
A
Caballero Carpena
O
O
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging*; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D019690:Technetium Tc 99m Exametazime
D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime