Technetium‐99m HMPAO‐Labeled Leukocyte Imaging Compared with Endoscopy, Ultrasonography, and Contrast Radiology in Children with Inflammatory Bowel Disease

Abstract

ABSTRACTBackgroundThe 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).MethodsTwenty‐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, 1 with granulomatous disease, and 1 with Behçet's disease) were included. Endoscopic, ultrasonographic, and contrast radiologic examinations were realized for 28, 23, and 19 children respectively.ResultsSensitivity 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).ConclusionsLeukocyte‐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.