Detection of inflammatory bowel disease in pediatric patients with technetium-99m-HMPAO-labeled leukocytes.

UNLABELLED: Technetium-99m-HMPAO-labeled leukocyte imaging is now an accepted technique in the assessment of adult patients with inflammatory bowel disease (IBD), but its role in pediatric patients has not been studied.

METHODS

We evaluated the efficacy of 99mTc-HMPAO-labeled leukocyte imaging in 21 children. We studied 16 children with active IBD (4 ulcerative colitis, 10 Crohn's disease, 1 indeterminate colitis, 1 C-difficile) and 5 controls.

RESULTS

The sensitivity and specificity for active bowel inflammation were excellent. The intensity of uptake noted in most patients rendered image interpretation easy and straightforward. The inclusion of a tail on detector (TOD) view and anterior standing view of the abdomen is important. All patients with ulcerative colitis showed rectosigmoid disease and no small bowel activity, whereas, all patients with Crohn's disease showed discontinuous uptake and often small bowel activity. It was therefore possible to differentiate ulcerative colitis from Crohn's disease on the basis of location and distribution.

CONCLUSION

The 99mTc-HMPAO-labeled leukocyte scan is an excellent technique for the detection, localization and characterization of IBD in children.