Papós M, Várkonyi A, Láng J, Buga K, Tímár E, Polgár M, Bódi I, Csernay L
Department of Nuclear Medicine, Albert Szent-Györgyi Medical University, Szeged, Hungary.
J Pediatr Gastroenterol Nutr. 1996 Dec;23(5):547-52. doi: 10.1097/00005176-199612000-00006.
Leukocyte scintigraphy (LS) was performed in 20 pediatric patients with inflammatory bowel disease (IBD: 10 with ulcerative colitis, 2 with indeterminate colitis, and 8 with Crohn disease) in different stages of clinical activity. Leukocytes were separated from 15 to 60 ml venous blood and were labeled in vitro with [99mTc]HM-PAO. The segmental extent (small intestine; ascending, transverse, and descending colon; and recto-sigmoideum) of the process was determined by LS. The uptake of each bowel segment was scored in relation to the bone marrow uptake. The scintigraphic activity, calculated by summing the segment scores, was compared with laboratory parameters. The mean labeling efficacy was 76% (60-86%). The segmental extent of the process determined by LS was compared with the results of barium enema or colonoscopy with regard to 32 bowel segments. The sensitivity, specificity, and accuracy of LS were 93, 88, and 91%, respectively. Two extraintestinal manifestations (abdominal abscess and joint involvement) were also detected by LS. These lesions were verified by computed tomography (CT) (abscess) and on the basis of the clinical outcome (arthritis). The scintigraphic activity correlated with the C-reactive protein (CRP) level (r = 0.82, p < 0.001), the alpha 2-globulin level (r = 0.63, p < 0.02), the sedimentation rate (r = 0.51, p < 0.05), and the fS iron level (r = -0.66, p < 0.005). LS is applicable in pediatric patients. The method is an excellent technique for assessment of the extent of IBD in children. Extraintestinal manifestations of IBD can also be investigated by LS. The scintigraphic activity is a useful parameter for determination of the activity of IBD in children.
对20例处于不同临床活动阶段的炎症性肠病（IBD：10例溃疡性结肠炎、2例不确定性结肠炎、8例克罗恩病）患儿进行了白细胞闪烁扫描（LS）。从15至60毫升静脉血中分离白细胞，并在体外使用[99mTc]HM-PAO进行标记。通过LS确定病变的节段范围（小肠；升结肠、横结肠和降结肠；以及直肠乙状结肠）。根据骨髓摄取情况对每个肠段的摄取进行评分。将各节段评分相加计算得出的闪烁扫描活性与实验室参数进行比较。平均标记效率为76%（60 - 86%）。就32个肠段而言，将LS确定的病变节段范围与钡剂灌肠或结肠镜检查结果进行了比较。LS的敏感性、特异性和准确性分别为93%、88%和91%。LS还检测到了两种肠外表现（腹部脓肿和关节受累）。这些病变通过计算机断层扫描（CT）（脓肿）以及临床结果（关节炎）得到了证实。闪烁扫描活性与C反应蛋白（CRP）水平（r = 0.82，p < 0.001）、α2球蛋白水平（r = 0.63，p < 0.02）、血沉（r = 0.51，p < 0.05）以及铁蛋白水平（r = -0.66，p < 0.005）相关。LS适用于儿科患者。该方法是评估儿童IBD范围的一项出色技术。IBD的肠外表现也可通过LS进行研究。闪烁扫描活性是确定儿童IBD活动度的一个有用参数。
