Aburano T, Saito Y, Shuke N, Ayabe T, Kohgo Y, Sato J, Ishikawa Y
Department of Radiology, Asahikawa Medical College Hospital, Japan.
Clin Nucl Med. 1998 Aug;23(8):509-13. doi: 10.1097/00003072-199808000-00003.
The diagnostic value of Tc-99m leukocyte imaging for evaluating disease activity and monitoring treatment response in ulcerative colitis was compared with that of colonoscopy. A total of 48 studies were performed in 28 patients with ulcerative colitis. Forty-six studies had both Tc-99m leukocyte imaging and colonoscopy within 2 weeks of each other, and the remaining two studies had only Tc-99m leukocyte imaging. In 46 studies, semiquantitative grading of colonic radioactivity by comparison with iliac crest marrow activity on radionuclide imaging correlated well with macroscopic grading based on Matts' criteria on colonoscopy. Fourteen (82%) of 17 studies with slight colonoscopic change showed a negative result on the radionuclide image. In 15 patients treated with glucocorticoids or leukapheresis, radionuclide imaging showed nearly the same statistical results as colonoscopy in monitoring treatment response. Tc-99m leukocyte imaging could be used as an alternative to colonoscopy to evaluate the disease activity of ulcerative colitis or to monitor the treatment response, although it is insensitive for detecting disease with only slight macroscopic changes.
将锝-99m白细胞显像用于评估溃疡性结肠炎疾病活动度及监测治疗反应的诊断价值，与结肠镜检查进行了比较。对28例溃疡性结肠炎患者共进行了48项研究。其中46项研究在彼此相隔2周内同时进行了锝-99m白细胞显像和结肠镜检查，其余两项研究仅进行了锝-99m白细胞显像。在46项研究中，通过放射性核素显像将结肠放射性与髂嵴骨髓活性进行比较的半定量分级，与基于结肠镜检查的马茨标准的宏观分级相关性良好。17项结肠镜检查仅有轻微改变的研究中，有14项（82%）放射性核素显像结果为阴性。在15例接受糖皮质激素或白细胞去除术治疗的患者中，放射性核素显像在监测治疗反应方面显示出与结肠镜检查几乎相同的统计学结果。锝-99m白细胞显像可作为结肠镜检查的替代方法，用于评估溃疡性结肠炎的疾病活动度或监测治疗反应，尽管其对仅伴有轻微宏观改变的疾病检测不敏感。
