LEUKOCYTE MIGRATION IN ACUTE COLONIC INFLAMMATORY BOWEL-DISEASE - COMPARISON OF HISTOLOGICAL ASSESSMENT AND TC-99M-HMPAO LABELED LEUKOCYTE SCAN

Citation
D. Stahlberg et al., LEUKOCYTE MIGRATION IN ACUTE COLONIC INFLAMMATORY BOWEL-DISEASE - COMPARISON OF HISTOLOGICAL ASSESSMENT AND TC-99M-HMPAO LABELED LEUKOCYTE SCAN, The American journal of gastroenterology, 92(2), 1997, pp. 283-288
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenterology & Hepatology
ISSN journal
0002-9270
Volume
92
Issue
2
Year of publication
1997
Pages
283 - 288
Database
ISI
SICI code
0002-9270(1997)92:2<283:LMIACI>2.0.ZU;2-N
Abstract
Noninvasive leukocyte scintigraphy for assessment of localization, ext ent, and degree of active inflammation in acute colonic inflammatory b owel disease have been shown to correlate well with endoscopy. This st udy compared findings of mucosal leukocyte migration assessed histolog ically with those of technetium 99m hexamethylpropylene-amineoxime-lab eled leukocyte scintigraphy. Patients and methods: Twenty-one patients hospitalized because of a first attack or a relapse of known inflamma tory bowel disease were investigated using leukocyte scintigraphy foll owed by total colonoscopy with multiple biopsies within 24 h. Histolog ical interpretation focused on the degree of segmental mucosal leukocy te infiltration. Results: Fourteen patients with ulcerative colitis (U C) and seven with colonic Crohn's disease (CD) were included. With the use of histology as the reference method, maximal proximal disease ex tent was correctly assessed by the leukocyte scan in 11 patients (8 wi th UC, 3 with CD), although the rectal involvement was not visualized in 5. In seven patients, the extent assessments almost matched (+/- on e segment), and in the remaining three patients (two UC, one CD) the s can grossly misinterpreted active histological inflammation (greater t han or equal to +/- two segments). In patients with UC, the sensitivit y, specificity, and diagnostic accuracy concerning the extent of infla mmation were 0.84, 0.79, and 0.83, respectively. In patients with CD, the sensitivity was 0.79, and the diagnostic accuracy was 0.78. The re lative leukocyte scan activity score was less concordant with the degr ee of mucosal leukocyte infiltration but still significantly correlate d (r = 0.616, p < 0.0001 in UC patients and r = 0.441, p < 0.003 in CD patients). Conclusion: Images created by the technetium 99m hexamethy lpropylene-amineoxime-labeled leukocyte scan in acute colonic inflamma tory bowel disease correlate to mucosal leukocyte migration in terms o f proximal disease extent and, to a lesser degree, also to the intensi ty of mucosal inflammatory infiltration.