Computed tomography and granulocyte scintigraphy in active inflammatory bowel disease

Abstract

The accuracy of computed tomography (CT) and [99mTc]HMPAO granulocyte scintigraphy (GS) for detection of bowel localization, inflammatory activity, and complications in acute inflammatory bowel disease (IBD) was prospectively studied in 32 patients. Of each bowel segment, findings on CT and GS were scored by one blinded observer. Findings on operation or endoscopy served as the gold standard. In Crohn's disease (CD, 17 patients), CT detected bowel pathology (sensitivity 71%, specificity 98%), abscesses (sensitivity and specificity 100%), and fistulas (sensitivity 80%, specificity 100%). In CD, GS had a sensitive of 79% and a specificity of 98% for detection of inflammatory activity. The detection of complications with GS was poor. Segmental inflammatory activity correlated with endoscopy-operative findings for CT (r = 0/86, P < 0.0001) and GS (r = 0.86, P < 0.0001). In ulcerative colitis (UC, 15 patients), GS predicted proximal extension of bowel involvement better than CT. In CD, CT is Superior to GS for localization of both active and fibrostenotic bowel disease, and in detection of the abscesses and fistulas. In UC, GS showed proximal extension more accurately than CT.

CT and 99m Tc-WBC vs colonoscopy in the evaluation of inflammation and complications of inflammatory bowel diseases

“…There is only one prospective study, in 13 patients with IBD, that compares CT with colonoscopy (63% of segments reached by colonoscopy, for a total of 44 bowel segments). 23 CT had a lower sensitivity than the 99m Tc-WBC scan for detecting bowel inflammation (68% for CT and 85% for 99m Tc-WBC). No controls or IBD patients with quiescent disease were included in this study to evaluate the specificity of the findings on CT or 99m Tc-WBC scans.…”

Technetium leukocyte imaging in inflammatory bowel disease

“…In children with true-negative results of 99m Tc-WBC imaging, there were 24 true-negative results of UGI-small bowel follow-through and four equivocal results (lymphoid nodular hyperplasia vs Crohn's disease). In adults, studies have also suggested that 99m Tc-WBC imaging is superior to contrast radiology in assessing the extent and activity of IBD [20,40].…”

99mTc-Leucoscan in the evaluation of inflammatory bowel disease

“…Scintigraphy with 99m Tc-labelled white blood cells (WBCs) is routinely used for the assessment of IBD [3], but the procedure is time consuming and scintigraphy using a new agent could replace this technique. 99m TcLeucoscan scintigraphy, which takes about 5 min and in addition does not require direct interaction with patients' blood, was thought to be an ideal candidate for this purpose.…”