The Role of Scintigraphy in the Assessment of Inflammatory Bowel Disease in Childhood and Adolescence

Overview

Ulcerative colitis and Crohn’s disease are 2 chronic idiopathic diseases belonging to the group of inflammatory bowel diseases (IBD). These chronic diseases frequently begin in childhood or adolescence. Scintigraphy using 99mTc HMPAO labelled leukocytes is nowadays included into the group of examinations.The aim of this paper was detection of inflammation in children suspected of IBD, using LEUCO-SCINT (BANK SYS s.r.o.) by labelling white blood cells. The scintigraphic findings were compared with x-ray and endoscopy to determine the role of scintigraphy in the spectrum of examinations.25 children (15 boys, 10 girls) aged 3 - 17 years (average 12.1 years) suspected of IBD were examined. 6 of them had the final diagnosis of ulcerative colitis or Crohn’s disease and scintigraphy was done to evaluate the extent and activity of disease. The findings were compared with x-ray examinations and endoscopy.Methods of cell labelling: 14 - 60 ml of venous blood was taken using syringes containing an adequate amount of acid citrate dextrose (ACD) and hydroxyethyl starch (Plasmasteril). The cell separation and their labelling were performed according to the manufacturer’s instruction.The planar scintigraphic images of the abdomen were acquired after 30 minutes in young children and 1 hour in older children following the injection of 99mTc HMPAO labelled leukocytes. The tomographic scintigraphic abdominal images - SPECT (Single Photon Emission Tomography) were done after 1 - 2 hours and wholebody scintigraphy 3 hour after the injection of the labelled leukocytes X-ray examination (barium enema study or double-contrast enteroclysis) and endoscopy were performed in all children.12 children had pathological accumulation of labelled leukocytes in the abdomen. 13 children had negative scintigraphic findings. The scintigraphic, x-ray and endoscopic findings agreed in 95 %.99mTc HMPAO labelled leukocyte scintigraphy using LEUCO-SCINT (BANK SYS s.r.o.) is a sensitive and non-invasive method for detection and localization of IBD. In our opinions this method determines selection of patients indicated for the invasive x-ray and endoscopic examinations.

Key words:
inflammatory bowel disease (IBD), 99mTc HMPAO labelled leukocytes scintiography, childhood and adolescence