Crohn病及溃疡性结肠炎的^(99)Tc^m-HIgG定位显像

Scintigraphic assessment of bowel involvement and disease activity in Crohn disease and ulcerative colitis using ^(99)Tc^m-HIgG

目的 了解Crohn病和溃疡性结肠炎99Tcm HIgG炎症定位显像的图像特点 ,评估其对确定炎症病变部位、范围及活动程度的价值。方法 对照组 11例 ,男 7例 ,女 4例 ,平均年龄 (38± 10 )岁。确诊的溃疡性结肠炎患者 2 2例 ,Crohn病患者 19例 ,男 2 8例 ,女 13例 ,平均年龄 (35± 15 )岁。静脉注射99Tcm HIgG 370～ 740MBq(1mg)后 ,分别于 1,2 ,4,6h显像 ,必要时加做 2 4h显像 ,采用前后位及后前位全身显像 ,必要时加做局部平面及断层显像。结果 2 2例溃疡性结肠炎患者中 2 1例显像阳性 ,1例阴性 ,阳性率为 95 %。 19例Crohn病患者 17例阳性 ,2例阴性 ,阳性率为 89%。对照组均为阴性。上述阳性患者均在炎症性肠道疾病活动期 ,而阴性者均为缓解期。结论 99Tcm HIgG显像安全 ,简便 ,无副作用 ,对活动期炎症性肠道疾病诊断灵敏度高 。

Objective This study was made to evaluate the efficacy of 99 Tc m labeled human IgG ( 99 Tc m HIgG) as the tracer for early detection of bowel involvement and disease activity in Crohn disease and ulcerative colitis. Methods We have studied 22 cases with known ulcerative colitis and 19 cases with diagnosed Crohn disease. Twenty eight were men and 13 were women aged (35±15) years. 370～740 MBq(1 mg) of 99 Tc m HIgG was injected intravenously. The whole body scan (ANT and POST) were obtained after 1,2,4,6 h delays or 24 h if necessary. Whenever abnormal areas were found, multiple spot views were required. Results Twenty one out of 22 ulcerative colitis patients were found positive. The positive rate was 95%. Seventeen out of 19 Crohn disease patients were positive and the positive rate was 89%. All the negative cases were not with active disease. With respect to the activity of the disease, the positive rate of 99 Tc m HIgG scan in ulcerative colitis was 100% equal to the endoscopy. While in Crohn disease the positive rate with 99 Tc m HIgG, endoscopy and X ray were 100%,30% and 94% respectively. In both diseases while it was in the remission stage, the scans were normal. Conclusions ① 99 Tc m HIgG is a sensitive and reliable method for detecting the presence and extent of inflammatory bowel disease. ②It can provide clinically useful assessment of disease activity and the response to therapy. ③It is safe, convenient and of no side effects.