title: Scintigraphic evaluation of acute pancreatitis patients with 99mTc-HMPAO-labelled leukocytes.
abstract: OBJECTIVE
  To demonstrate the localization of leukocytes in the pancreas during acute pancreatitis and to evaluate the potential use of 99mTc-HMPAO-labelled leukocytes in the diagnostic assessment of patients with acute pancreatitis.
  
  
  METHODS
  The study was performed with 20 patients (11 females, nine males; ranging in age from 26 to 86 years, mean 55 years). Labelled leukocyte scintigraphy using planar imaging was performed on all patients, seven of whom were also examined by single photon emission computed tomography (SPECT). According to Ranson criteria, 10 patients had mild pancreatitis (group A), six had severe pancreatitis (group B) and four had necrotic pancreatitis (group C). Twelve patients had biliary pancreatitis and the other eight patients had no obvious cause.
  
  
  RESULTS
  All patients of group C, four of group B, two of group A had a positive leukocyte scan. The positive leukocyte scintigraphy value for the detection of a lethal course of acute pancreatitis was 100%; of a severe course, 66.7%; and of a mild course, 20%. These findings are statistically significant (P=0.005 in chi-squared tests result). The results of leukocyte scintigraphy compared with those of CT were also statistically significant (P=0.001 in chi-squared tests). All the patients diagnosed with pancreatic necrosis by CT had a positive leukocyte scan, but only three of 13 patients without pancreatic necrosis that could be detected by computed tomography had a positive leukocyte scan.
  
  
  CONCLUSIONS
  There was a significant correlation between the severity of the disease and leukocyte infiltration. Considering these results, we believe that leukocyte infiltration in acute pancreatitis can be demonstrated rapidly and accurately and by noninvasive 99mTc-HMPAO labelled leukocyte scintigraphy.
authors.affiliation: Department of Nuclear Medicine, Medical Faculty of Ataturk University, Erzurum, Turkey. uslusinav@hotmail.com
authors.forename: Hatice
authors.initials: H
authors.lastname: Uslu
authors.forename: Erhan
authors.initials: E
authors.lastname: Varoglu
authors.forename: Ahmet
authors.initials: A
authors.lastname: Balik
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yildirim
authors.forename: Rezan
authors.initials: R
authors.lastname: Bayrakdar
authors.forename: Bedri
authors.initials: B
authors.lastname: Seven
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000000981:diagnostic imaging* / Q000473:pathology*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime