chiniofon and Crohn-Disease

Topics: Crohn Disease; Granulocytes; Humans; Hydroxyquinolines; Leukapheresis; Leukocyte Count; Organometallic Compounds; Osteomyelitis; Oxyquinoline; Radionuclide Imaging

111Indium autologous mixed leucocyte scanning has recently been used for the investigation of Crohn's disease. Nineteen patients had indium scans to assess disease extent and activity. The scans were compared with conventional imaging techniques and indices of disease activity including clinical scores, ESR, CRP, and GI protein loss. In five patients with active disease the scans were negative and overall there was poor correlation between the scan scores and the other indices of disease activity. Indium scanning correctly located extent of disease in only 58% of patients. 111Indium mixed leucocyte scanning may be more suited for the assessment of disease extent and activity in severely ill patients with Crohn's disease.

Topics: Adolescent; Adult; Crohn Disease; Female; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

The in vitro and in vivo behaviour of 99Tcm-HMPAO (hexamethylpropyleneamineoxime) (n = 12) and 111In-oxine (n = 11) labelled granulocytes, isolated by density-gradient centrifugation (Metrizamide/plasma gradients), was compared in patients with suspected inflammatory diseases. The in vitro elution of both labels and the viability of the labelled cells (99Tcm, 98.5%; 111In, 96.5%) was comparable but the labelling efficiency was different (99Tcm, 44 +/- 13%; 111In, 72.5 +/- 5.5%). In vivo, the lung (t1/2 max: 7.7 min), liver and spleen perfusion patterns were nearly identical; the image quality for detail in 99Tcm scans was superior to 111In images. The blood disappearance curves of 99Tcm and 111In were comparable. In the small number of patients examined all infections could be diagnosed correctly, without false-positive or false-negative results. Disadvantageous is the renal excretion of 99Tcm complexes (3+% over 20 h) with kidney and bladder activity from the beginning of the study. The biliary excretion in half of the patients (n = 6) with unspecific positive small and large bowel visualization and the late intestinal excretion also render the diagnosis more difficult. The recommended best imaging times for abdominal and retroperitoneal inflammations are 30 min to 2 h after injection. Late scans in septic prosthetic joints have disproportionate long acquisition times. As a potential cell labelling compound, 99Tcm-HMPAO has a promising future in comparison to 111In scans because of the good availability of 99Tcm, the image quality and the lower radiation exposure to the patient when lower activities for the early diagnosis of abdominal inflammatory diseases are reinjected.

Topics: Colitis, Ulcerative; Crohn Disease; Female; Granulocytes; Humans; Hydroxyquinolines; Indium Radioisotopes; Inflammation; Isotope Labeling; Joint Diseases; Lung Diseases; Male; Organometallic Compounds; Oximes; Oxyquinoline; Polycystic Kidney Diseases; Radionuclide Imaging; Technetium; Technetium Tc 99m Exametazime

17 patients with known small bowel involvement in Crohn's disease (clinically active, n = 14; clinically inactive, n = 3) were examined within 8 days via barium enemas of the small bowel (Pansdorf's method or enteroclysis) and by 111In-oxine labelled leucocytes. From 19 radiologically diagnosed small bowel stenoses 14 were classified as inflammatory and 5 as non-inflammatory. The leucocyte scan also showed 14 inflammatory stenoses. The not inflamed stenoses could not be diagnosed scintigraphically. The barium enemas of the small bowel and the leukocyte scans both correctly diagnosed the acute inflamed segments. The inability to show non-inflamed segments (n = 5) and to localise small bowel stenoses exactly is disadvantageous in the scan. The advantage of the leucocyte scan is a non-invasive examination without specific bowel preparation and the possibility to diagnose additionally inflamed large bowel segments (n = 4), fistulas and abscesses (n = 2). The leucocyte scan offers a useful expansion of the diagnostic tools in small bowel diseases, especially in radiological problems in patients with Crohn's disease.

Topics: Adult; Aged; Crohn Disease; Female; Humans; Hydroxyquinolines; Indium; Intestinal Obstruction; Intestine, Small; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

The usefulness of scintigraphy with 111In-oxine-labelled autologous leucocytes was investigated in 27 patients with inflammatory bowel disease (IBD): 16 with ulcerative colitis and 11 with Crohn's disease. Scans were performed 2-4 h (early scan) and at 24 h (late scan) after leucocyte reinjection. No false-negative results occurred in the early scan; however, in the late scan, 2 patients with Crohn's disease had a normal scintigram. A new index of activity (Il) based on the number and relative activity of abnormal 111In-leucocyte zones was used for scan quantitation. All patients with clinically active IBD had Il greater than or equal to 2. The scintigraphic index showed a significant correlation with the Harvey clinical index, especially in patients with ulcerative colitis. Our results suggest that an early scan (2-4 h) provides useful information in cases of IBD, and that Il greater than or equal to 2 is indicative of the degree of disease activity in such patients.

Topics: Adolescent; Adult; Colitis, Ulcerative; Crohn Disease; False Negative Reactions; Female; Humans; Hydroxyquinolines; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

111In-oxine "pure" granulocyte scanning allows an exact localisation of infiltrated bowel in Crohn's disease and ulcerative colitis. Fecal excretion of labeled granulocytes yields a good parameter of disease activity. In comparison to 111In-oxine "mixed" leukocyte scanning, this method is more specific in assessing disease activity and more sensitive in localising diseased bowel. Radiation exposure to blood cells is not as high as in "mixed" leukocyte scanning. Pure granulocytes were isolated by discontinuous density gradient centrifugation of an isolated "mixed" leukocyte fraction.

Topics: Adult; Colitis, Ulcerative; Crohn Disease; Female; Granulocytes; Humans; Hydroxyquinolines; Indium; Isotope Labeling; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging

Topics: Crohn Disease; Feces; Humans; Hydroxyquinolines; Indium; Leukocytes; Oxyquinoline; Radioisotopes; Radionuclide Imaging

Topics: Adult; Colitis, Ulcerative; Colon; Crohn Disease; Female; Humans; Hydroxyquinolines; Ileum; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging

Patients with Crohn's disease (n = 22), ulcerative colitis (n = 5), inactive Whipple's disease (n = 1), irritable bowel syndrome (n = 2), arthritis (n = 1) and Yersinia infections (n = 2) were examined with 111In-oxine labelled "mixed" leukocyte preparations (n = 12) or with 111In-oxine labelled "pure" granulocyte preparations (n = 21). Compared with barium enemas of the gut and colonoscopy, performed within of one week in 31 patients there was a correct location of infiltrated bowel segments in 24 patients (78%). The scan diagnosed more infiltrated segments in 4 patients (13%). In 3 patients it failed to diagnose one inflamed segment. In 24 patients the faecal 111In-excretion was expressed as percentage of the reinjected 111In-activity. All patients with non inflammatory bowel diseases and patients with inactive inflammatory bowel diseases excreted less than 2% of the reinjected 111In-activity. All but one female patient with active bowel disease excreted more than 2%. In 24 patients the correlation of ESR, CDAI and A.I. was available. There was a good correlation between ESR (r = 0.77, P less than 0.001), A.I. (r = 0.61, p less than 0.001) and the %-faecal faecal excretion. The 111In-labelling of white blood cells, especially of granulocytes, seems to be a reliable alternative method to localize infiltrated bowel segments and to assess disease activity in patients with inflammatory bowel diseases, compared to usually performed radiological, endoscopical and clinical methods.

Topics: Adult; Aged; Colitis, Ulcerative; Colon; Crohn Disease; Female; Granulocytes; Humans; Hydroxyquinolines; Ileum; Indium; Leukocytes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Rectum

Recent reports have indicated a possible role for 111Indium leucocyte scintigraphy in the management of patients with acute inflammatory bowel disease. Our experience with this technique in 15 patients (nine with ulcerative colitis, six with Crohn's disease) is described. Perfect agreement was not obtained between scintigraphic appearances and other conventional means in the assessment of extent of disease. Good correlation, however, was found between disease activity and recovery of labelled leucocytes in the faeces. While this latter finding could be used as an objective means of assessing response to therapy, it is concluded that conventional indium scintigraphy, using indium oxine-labelling of mixed leucocytes, is insufficiently reliable to replace usual methods for determining extent of disease in patients with inflammatory bowel disease.

Topics: Colitis, Ulcerative; Crohn Disease; Evaluation Studies as Topic; Feces; Humans; Hydroxyquinolines; Indium; Leukocytes; Organometallic Compounds; Oxyquinoline; Prednisolone; Radioisotopes; Radionuclide Imaging