Coloproctology Department, Hospital de Base do Distrito Federal, SMHS área especial Q.101 Asa Sul, Brasília, Distrito Federal, Brazil.
Brasília University (UnB), Brasília, Brazil.
Ann Nucl Med. 2020 Apr;34(4):263-271. doi: 10.1007/s12149-020-01447-w. Epub 2020 Feb 19.
The main goal in Crohn´s disease (CD) is a sustained suppression of inflammatory activity associated with mucosa healing in endoscopic evaluation. During clinical routine, there are small numbers of good markers to monitor inflammatory activity under treatment. We postulated that Oral Gallium Citrate Scintigraphy is able to mark inflammatory disease in mucosa and deep inflammation in CD, when used in oral form.
Measure the accuracy of Oral Gallium Citrate Scintigraphy in intestinal inflammatory activity of Crohn´s disease.
In a prospective consecutive cross-sectional study from January 2018 to June 2019, the ileocolonic region of 32 patients with CD were studied by dividing into four regions of interest (ROI) from the ileum to the rectum. A total of 128 intestinal segments were analyzed in cluster data. Accuracy values of Oral Gallium Scintigraphy and colonoscopy tests were evaluated with the histological reference test. Values of the respective receiver operating characteristic (ROC) curves were obtained and compared. The reliability between the tests was evaluated by Kappa statistical with the segment-level analyses using variance adjustments. All statistical analyses were performed with a test significance level of 0.05.
The study population included 32 patients with CD (10 men, 22 women; average age 39 years). Disease time was five years on average. Anti-TNFs treatment was found in 71%. The most found phenotype of the Montreal classification was L3. Differences in ROC curves for colonoscopy (0.94) and Oral Ga Scintigraphy (0.96) did not show significant value (p = 0.32). The sensitivity of scintigraphy to detect intestinal inflammatory activity in CD was 64%, specificity of 96% and accuracy of 84%. A high agreement was found between oral scintigraphy and histological measurements with kappa = 0.64.
Oral Ga Scintigraphy had similar accuracy and agreement compared to colonoscopy in the identification of inflammatory activity in Crohn´s Disease. This new approach may be useful and less invasive for long term follow-ups.
克罗恩病（CD）的主要目标是在内镜评估中持续抑制与黏膜愈合相关的炎症活动。在临床常规中，用于监测治疗下炎症活动的良好标志物数量较少。我们推测，口服柠檬酸镓闪烁扫描术在口服形式下能够标记黏膜中的炎症性疾病和 CD 中的深部炎症。
测量口服柠檬酸镓闪烁扫描术在克罗恩病肠道炎症活动中的准确性。
在 2018 年 1 月至 2019 年 6 月期间进行的一项前瞻性连续横断面研究中，对 32 例 CD 患者的回肠-结肠区域进行研究，将其分为从回肠到直肠的四个感兴趣区域（ROI）。总共对 128 个肠段进行了聚类数据分析。用组织学参考测试评估了口服镓闪烁扫描术和结肠镜检查的准确性值。获得了各自接收者操作特征（ROC）曲线的值，并进行了比较。使用方差调整的节段级分析评估了测试之间的可靠性。所有统计分析的检验显著性水平均为 0.05。
研究人群包括 32 例 CD 患者（男 10 例，女 22 例；平均年龄 39 岁）。平均疾病时间为 5 年。发现 71%的患者接受了抗 TNF 治疗。蒙特利尔分类中最常见的表型为 L3。结肠镜检查（0.94）和口服 Ga 闪烁扫描术（0.96）ROC 曲线之间的差异无统计学意义（p=0.32）。闪烁扫描术检测 CD 肠道炎症活动的敏感性为 64%，特异性为 96%，准确性为 84%。口服闪烁扫描术与组织学测量之间的一致性很高，kappa=0.64。
与结肠镜相比，口服 Ga 闪烁扫描术在识别 CD 炎症活动方面具有相似的准确性和一致性。这种新方法可能对长期随访具有有用性和较小的侵入性。
