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Can ⁹⁹Tc^m HMPAO leucocyte scintigraphy distinguish between Crohn's disease and ulcerative colitis?

¹ Department of Nuclear Medicine, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK ² Department of Radiology, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK

Correspondence: ^* Address correspondence to Dr E P Wraight.

This paper has retrospectively analysed the ability of ⁹⁹Tc^m HMPAO leucocyte scintigraphy to distinguish Crohn's disease from ulcerative colitis. The diagnostic criteria were established by reviewing ⁹⁹Tc^m HMPAO leucocyte scintigrams in 123 patients with histologically proven Crohn's disease (83) or ulcerative colitis (40). Uptake in the right iliac fossa with or without other segments of colon, irregular bowel uptake, small bowel uptake or colonic activity with rectal sparing were all strongly suggestive of Crohn's disease. Left sided colitis was found to indicate ulcerative colitis. Total colitis occurred in both ulcerative colitis and Crohn's disease.The criteria were later tested in an additional 62 patients with excellent results (accuracy 98%). In 63 patients in whom the results of barium radiology were also available, the accuracy of scintigraphy was higher (93%and 83%, respectively). We conclude that ⁹⁹Tc^m HMPAO leucocyte scintigraphy can accurately distinguish between Crohn's disease and ulcerative colitis in a large proportion of cases and appears to be more reliable than conventional radiology.

Received for publication August 23, 1993. Revision received October 4, 1993. Accepted for publication October 14, 1993.

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