Llorente E, Bittini A, Domínguez P, Almoguera I, Martínez M L, Alonso J C, Lara V G, Jaime B, Pérez Vázquez J M
Servicio de Medicina Nuclear, Hospital General Universitario, Gregorio Marañón, Madrid.
Rev Esp Enferm Dig. 1996 Sep;88(9):599-604.
The value of 99mTc-hexamethylpropyleneamine oxime (HMPAO) leukocyte images has been confirmed in patients with Inflammatory Bowel Disease. We performed 121 scintigraphic examination. The results were evaluated by radiologic and/or endoscopic examinations. The patients were divided into three subgroups: A) patients with active disease and less than 15 days of corticotherapy (n = 42). B) patients with active disease and more than 15 days of corticotherapy (n = 31). C) asymptomatic patients (n = 48). Over all sensitivity and specificity were 86% and 92.2% respectively. The sensitivity in subgroup A was 97.5% and 70% in the subgroup B. In the subgroup A the isotopic study showed the entire area of active inflammation in 95% (38/40) and colonoscopy in 32.5% (13/40). The leucocyte scanning showed clear pathologic activity in the ileum with a sensitivity of 86%. We conclude that 99mTc-leukocyte scintigraphy is the best method to assess the location of active inflammation in patients with less than 15 days of treatment. Scintigraphy was best in the assessment of active disease especially in Crohn's disease of the small bowel.
99m锝-六甲基丙烯胺肟(HMPAO)白细胞显像在炎症性肠病患者中的价值已得到证实。我们进行了121次闪烁扫描检查。结果通过放射学和/或内镜检查进行评估。患者被分为三个亚组:A)患有活动性疾病且接受皮质激素治疗少于15天的患者(n = 42)。B)患有活动性疾病且接受皮质激素治疗超过15天的患者(n = 31)。C)无症状患者(n = 48)。总体敏感性和特异性分别为86%和92.2%。亚组A的敏感性为97.5%,亚组B为70%。在亚组A中,同位素研究显示95%(38/40)的患者存在活动性炎症的整个区域,而结肠镜检查显示32.5%(13/40)的患者存在该区域。白细胞扫描显示回肠有明显的病理活性,敏感性为86%。我们得出结论,99m锝-白细胞闪烁扫描是评估治疗少于15天的患者活动性炎症部位的最佳方法。闪烁扫描在评估活动性疾病方面表现最佳,尤其是在小肠克罗恩病中。