Charron M, del Rosario J F, Kocoshis S
Division of Nuclear Medicine, Department of Radiology, Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA.
Pediatr Radiol. 1998 Nov;28(11):871-7. doi: 10.1007/s002470050486.
Studies have suggested that scans with technetium-tagged white blood cells (WBC-Tc99m) may be equal to endoscopy in the assessment of extent and activity of inflammatory bowel disease (IBD).
We have retrospectively examined the accuracy of WBC-Tc99m scans in differentiating continuous from discontinuous colitis in pediatric IBD.
There were 207 children in the study (96 boys, 111 girls, median age 13 years). This included 29 controls - children with no gastrointestinal disease (NL) who underwent WBC-Tc99m scans for other medical problems. Scans were obtained at 30 minutes and 2-4 hours following injection. Scans were interpreted as showing continuous colitis, discontinuous colitis, or no colitis.
In the 77 children with active Crohn's disease (CD) of the colon, the scans revealed discontinuous uptake in 63 children and continuous uptake in 14. In the 29 children with ulcerative colitis (UC), 23 scans showed continuous uptake and 6 revealed discontinuous uptake. Two of these 6 showed focal activity near the appendix, and subclinical appendicitis could not be excluded. Another child was bleeding and the scan could have been misinterpreted as showing small- bowel inflammation. In the last three patients, skip areas were clearly identifiable. In none of these last three patients were the biopsies typical of CD (i. e., no granuloma was identified) nor was inflammation patchy. In summary, of the 106 scans showing inflammation, 6 were classified into the wrong group.
These data show that WBC-Tc99m scanning can be useful in distinguishing discontinuous from continuous colitis.
研究表明，用锝标记白细胞（WBC-Tc99m）进行扫描在评估炎症性肠病（IBD）的范围和活动度方面可能与内镜检查效果相当。
我们回顾性研究了WBC-Tc99m扫描在鉴别儿童IBD中连续性结肠炎与非连续性结肠炎方面的准确性。
本研究共纳入207名儿童（96名男孩，111名女孩，中位年龄13岁）。其中包括29名对照儿童，即无胃肠道疾病（NL）但因其他医疗问题接受WBC-Tc99m扫描的儿童。注射后30分钟和2 - 4小时进行扫描。扫描结果被解读为显示连续性结肠炎、非连续性结肠炎或无结肠炎。
在77名患有结肠活动性克罗恩病（CD）的儿童中，扫描显示63名儿童为非连续性摄取，14名儿童为连续性摄取。在29名溃疡性结肠炎（UC）儿童中，23次扫描显示连续性摄取，6次显示非连续性摄取。这6例中有2例在阑尾附近显示局灶性活动，不能排除亚临床阑尾炎。另一名儿童有出血情况，扫描结果可能被误判为显示小肠炎症。在最后3例患者中，跳跃区域清晰可辨。这最后3例患者的活检均不符合CD的典型表现（即未发现肉芽肿），炎症也不是斑片状的。总之，在106次显示炎症的扫描中，有6次被归入错误的类别。
这些数据表明WBC-Tc99m扫描在区分非连续性结肠炎与连续性结肠炎方面可能是有用的。
