Inflammatory bowel disease: value in diagnosis and management of MDCT-enteroclysis and 99mTc-HMPAO labeled leukocyte scintigraphy.

ABSTRACT

OBJECTIVES: The aims of this study are (a) to evaluate the reliability of Multidetector Computed Tomography Enteroclysis (MDCT-E) and (99m)Tc-HMPAO labeled leukocyte scintigraphy (TLLS), in inflammatory bowel disease, (b) to test the accuracy of the two techniques with regard to their histological results, (c) to define how each technique can influence the natural course of inflammatory bowel disease (IBD), (d) to assess the potential value of the two techniques combined. MATERIALS AND METHODS: Thirty-seven patients with suspected IBD underwent MDCT-E and TLLS. We made a separate assessment of the results shown by the two methods and then compared and contrasted the histological results of the two. The latter, however, were either disappointing or not available in 15 patients who, for this reason, had to be dismissed from the study. As result, the number of participants eventually dropped to 22 subjects: 12 women, 10 men with an average age of 44 years. RESULTS: MDCT-E and TLLS were successful in all patients. Sensitivity, specificity, and efficiency values have been reported as follows MDCT-E 62%, 100%, 64%,100%, 11%, respectively. TLLS 90%, 100%, 91%, 100%, 33%, respectively. The two methods combined 95%, 100%, 95%, 100%, 50%, respectively. CONCLUSIONS: The two techniques can be employed in different stages of the natural course of the disease. In our experience, TLLS proved itself to be useful in the diagnosis of the disease and the assessment of its development. Conversely, MDCT-E proved itself to be more reliable in identifying the seat and the extent of the disease inside and outside the bowel wall as well as potential intra-peritoneal and extra-intestinal complications. The combined use of the two methods represents the Criterion Standard for diagnosing IBD with imaging.