Value of technetium-99m HMPAO-labelled leucocyte scintigraphy as an initial screening test in patients suspected of having inflammatory bowel disease
| Autor: | Wendy B. Tindale, Derek Holdsworth, Mustafa H. Giaffer |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Time Factors chemistry.chemical_element Colonic Diseases Functional Technetium Scintigraphy Asymptomatic Inflammatory bowel disease Technetium Tc 99m Exametazime Crohn Disease Oximes Leukocytes medicine Humans False Positive Reactions Radionuclide Imaging Irritable bowel syndrome Hepatology medicine.diagnostic_test business.industry Indium Radioisotopes Gastroenterology Organotechnetium Compounds Inflammatory Bowel Diseases medicine.disease digestive system diseases Endoscopy Intestines chemistry Case-Control Studies Female medicine.symptom business Nuclear medicine Technetium-99m |
| Zdroj: | European Journal of Gastroenterology & Hepatology. 8:1195-1200 |
| ISSN: | 0954-691X |
| Popis: | Objective : This study was designed to evaluate the role of technetium-99m ( 99m Tc) hexamethyl propylene amine oxime (HMPAO)-labelled leucocyte imaging as an initial screening test in patients suspected of having inflammatory bowel disease (IBD). Patients and methods : Thirty-one patients in whom a final diagnosis of irritable bowel syndrome (IBS) was made (group 1) and another 33 patients with established Crohn's disease (group 2) were studied. All patients had 99m Tc HMPAO-labelled leucocyte scan with imaging at 40 and 120 min. Scans with abnormal bowel uptake were considered positive and this uptake was quantified by visual grading and computer-based methods (scan score). Group 1 patients with positive 99m Tc HMPAO scan underwent an indium-111 ( 111 ln)-labelled leucocyte scan (imaging at 180 min) followed by endoscopy and barium radiology as deemed necessary in order to verify the 99m Tc HMPAO result. Results : Three scan patterns were seen : well localized and unequivocally positive scans at both 40 min and 2 h were obtained from 28 patients. All but one had established Crohn's disease. Diffuse bowel uptake was seen in 14 scans. Ten of these (false positive) were obtained from symptomatic patients with IBS and four (false negative) from patients with asymptomatic Crohn's disease. No bowel uptake at 40 min and 2 h was seen in 22 scans. All but two of these (who had quiescent Crohn's disease) were obtained from patients with IBS. Active Crohn's disease is associated with significantly higher scan score (mean ± SEM, 82.1±13.6) than the false positive scans (12.5±3.1, P≥0.001). Patients with false positive 99m Tc HMPAO scans had negative 111 ln scans, endoscopy and barium radiology. Conclusion : Bowel scanning using either 111 ln or 99m Tc HMPAO is useful in excluding active IBD. Because of radiation dose, image quality and availability 99m Tc may be preferred to 111 ln. |
| Databáze: | OpenAIRE |
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