DETECTION OF INFLAMMATORY BOWEL-DISEASE IN PEDIATRIC-PATIENTS WITH TECHNETIUM-99M-HMPAO-LABELED LEUKOCYTES

Technetium-99m-HMPAO-labeled leukocyte imaging is now an accepted tech nique in the assessment of adult patients with inflammatory bowel dise ase (IBD), but its role in pediatric patients has not been studied. Me thods: We evaluated the efficacy of Tc-99m-HMPAO-labeled leukocyte ima ging in 21 children. We studied 16 children with active IBD (4 ulcerat ive colitis, 10 Crohn's disease, 1 indeterminate colitis, 1 C-difficil e) and 5 controls. Results: The sensitivity and specificity for active bowel inflammation were excellent. The intensity of uptake noted in m ost patients rendered image interpretation easy and straightforward. T he inclusion of a tail on detector (TOD) view and anterior standing vi ew of the abdomen is important. All patients with ulcerative colitis s howed rectosigmoid disease and no small bowel activity, whereas, all p atients with Crohn's disease showed discontinuous uptake and often sma ll bowel activity. It was therefore possible to differentiate ulcerati ve colitis from Crohn's disease on the basis of location and distribut ion. Conclusion: The Tc-99m-HMPAO-labeled leukocyte scan is an excelle nt technique for the detection, localization and characterization of I BD in children.