Are Tc-99m leukocyte scintigraphy and SBFT studies useful in children suspected of having inflammatory bowel disease?

OBJECTIVE: The goal of this retrospective study was to assess whether Tc-99 m-white blood cell (WBC) scintigraphy and upper gastrointestinal small bowe l follow-through UGI-SBFT) could exclude inflammation in children suspected of having inflammatory bowel disease (IBD). METHODS: Of a population of 313 children who had a Tc-99m-WBC scan, 130 chi ldren were studied exclusively to rule out IBD. Sixty-nine colonoscopies wi th biopsies were done within a short time interval of the Tc-99m-WBC scans. There were also 51 controls studied with 99mTc-WBC scintigraphy. RESULTS: Of the 130 children studied to exclude IBD, the final diagnosis wa s Crohn's disease in 27, ulcerative colitis in nine, miscellaneous colitis in 13, probably normal in 42, and normal in 39. The Tc-99m-WBC scans were p ositive in all but three newly diagnosed Crohn's disease, ulcerative coliti s, or miscellaneous colitis children. The false-negative Tc-99m-WBC studies were seen in children with mild inflammation on biopsies and normal UGI-SB FT studies. Tn the 46 children with a true-positive Tc-99m-WBC scan, 81% (1 7/21) of UGI-SBFT studies were normal. In five children with equivocal UGI- SBFT studies, the Tc-99m-WBC scan correctly predicted if inflammation was p resent in the terminal ileum. CONCLUSIONS: Our results suggest that Tc-99m-WBC is useful as an initial sc reening modality to exclude IBD, and is more sensitive than UGI-SBFT studie s. (C) 2000 by Am. Cell. of Gastroenterology.