Noninvasive Diagnosis of Small Bowel Crohnʼs Disease: Combined Use of Bowel Sonography and Tc-99M-Hmpao Leukocyte Scintigraphy

Abstract

BS and LS are 2 accurate techniques for the diagnosis of small bowel CD, and their combined use can be recommended as an early diagnostic approach to patients in which the disease is suspected. SBE remains the best procedure for the definition of the location and extension of the disease.

Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohnʼs disease

“…However, when results were separately calculated for the Crohn's Disease patients, the specificity was lower, 63%. The specificity is lower than previously reported 11,[42][43][44] and probably reflects the small number of patients without macroscopic findings in our cohort, implying a selection bias. Since this is the first study of leukocyte scintigraphy compared with complete endoscopic evaluation of the small bowel, our results should be considered more reliable than studies using indirect methods to demonstrate inflammation.…”

“…Since this is the first study of leukocyte scintigraphy compared with complete endoscopic evaluation of the small bowel, our results should be considered more reliable than studies using indirect methods to demonstrate inflammation. The results of this study, together with our previous results for the colon, 22 indicate that the exametazime scan can be used for the detection of bowel inflammation and also be used as a screening test for inflammatory bowel disease, 2,12 possibly with the exception for very proximal Crohn's disease both in adults (Table 3) 44 and in children. 43,45 Several studies in children have shown results comparable to those in adults.…”

Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

“…This imaging technique has also shown high sensitivity and specificity between 80% and 90% in adults and children for the correct detection of the involved bowel segment (60)(61)(62)(63). WBC scanning may also help to diagnose therapy resistance within days after the onset of therapy (64).…”

The potential of radiologic procedures in the diagnosis of inflammatory bowel disease

“…Использование энтерального кон-трастного средства в диагностике ВЗК повышает чувствительность метода, позволяет выявить по-ражения, не видимые при рутинном УЗИ [21,22]. Исследование выполняют стандартным сканером 3-5 МГц и при необходимости более детальной оценки дополняют сканером 7-12 МГц [23][24][25].…”

“…Его чувствительность и специфичность ва-рьируют от 76 до 92% [24,30]. У пациентов с дока-занным ВЗК значения чувствительности УЗИ еще выше, что обусловлено высокой настороженно-стью специалиста в выявлении характерных па-тологических изменений [31].…”