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Published online before print August 18, 2003, 10.1148/radiol.2291020692
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(Radiology 2003;229:70-74.)
© RSNA, 2003

Nuclear Medicine

Active Inflammatory Bowel Disease: Evaluation with 99mTc (V) DMSA Scintigraphy1

Ioannis E. Koutroubakis, MD, Sophia I. Koukouraki, MD, Philippos D. Dimoulios, MD, Antigoni A. Velidaki, MD, Nikolaos S. Karkavitsas, MD, PhD and Elias A. Kouroumalis, MD, PhD

1 From the Departments of Gastroenterology (I.E.K., P.D.D., E.A.K.) and Nuclear Medicine (S.I.K., A.A.V., N.S.K.), University Hospital Heraklion, Voutes, 71110 Heraklion, Crete, Greece. Received June 10, 2002; revision requested August 8; final revision received February 24, 2003; accepted March 12. Address correspondence to I.E.K. (e-mail: ktjohn@her.forthnet.gr).

PURPOSE: To evaluate the use of pentavalent (V) technetium 99m (99mTc) dimercaptosuccinic acid (DMSA) scintigraphy for the assessment of disease activity in patients with inflammatory bowel disease (IBD).

MATERIALS AND METHODS: 99mTc (V) DMSA scintigraphy was performed in 76 patients. There were 36 patients with active IBD (11 with ulcerative colitis, 25 with Crohn disease), 28 patients with inactive disease (eight with ulcerative colitis, 20 with Crohn disease), and 12 patients with miscellaneous bowel disease. Sensitivity and specificity of 99mTc (V) DMSA scintigraphy in the diagnosis of IBD were calculated. In the group with active IBD, the disease activity and laboratory indices, as well as the endoscopic and histologic activity, were compared with the scanning activity index. Correlation coefficients between them were calculated with the Spearman rank test.

RESULTS: 99mTc (V) DMSA scintigraphy had a 92% (33 of 36) sensitivity and an 86% (24 of 28) specificity in the detection of active IBD. A significant correlation between disease activity indices and scintigraphy score was demonstrated. Endoscopic and histologic activity was significantly correlated (P = .005 and .02, respectively, overall disease activity) with the scanning activity score. Of the group of patients with miscellaneous bowel disease, three with ischemic colitis had negative findings at scintigraphy.

CONCLUSION: 99mTc (V) DMSA scintigraphy provides a noninvasive, practical, and accurate assessment of IBD activity.

© RSNA, 2003

Index terms: Colitis, ulcerative, 75.261 • Crohn disease, 75.262 • Enteritis, 75.262 • Inflammation, radionuclide studies, 75.12161, 75.1217 • Intestines, radionuclide studies, 75.12161, 75.1217




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