^99mTc-hIgG在炎症性肠病诊断与随访中的临床应用

评价^99mTc-hIgG象法在炎症性肠病定位、疗效随访和预测复发中的临床价值。方法：对54例临床确诊的炎症性肠病病人在正规治疗前、41例经治疗症状得“控制和16例随访过程中症状复发者分别作^99mTc-hIgG核素显象检查。结果：①54例炎症性肠病病人中，50例出现阳性改变，其中2例假阳性，2例因发现新的放射性异常浓集修正丁诊断，4例假阴性，总灵敏度925％，特异性902％，准确率为88.9％；②41例临床缓解病人中，同位素显象出现相应减轻者38例，总符合率92．6％：④16例症状复发者中核素有异常浓集者15例，与临床的符台率为91．6％。结论：在炎症性肠病的诊断方法中，^99mTc-hIgG是一种非创伤性的辅助性方法，具灵敏度高、特异性好的优点，在疗效随访和预测复发方面有良好的实用价值。

Clinical Application of ~(99m)Tc-hIgG in the Diagnosis and Follow-up of Patients with Inflammatory Bowel Diseases

Background/Aims: To evaluate the clinical value of ~99mTc-hIgG scintigraphy in localization of inflammatory lesions, judgement of therapeutic efficacy and prediction of recurrence in patients with inflammatory bowel diseases. Methods: ~(99m)To-hIgG scintigraphy was performed in 54 in-patients with clinically diagnosed active ulcerative colitis and Crohn's disease before given regular treatment. The same examination was repeated in 41 follow-up cases 3 months after symptom-control and in 16 symptom-relapse patients. Results: 1. Abnormal isotopic accumulation was found in 50 cases at first scintigraphy, 2 were false-positive, in another 2 the diagnosis was changed because of new findings, and 4 were false-negative. The total sensitivity and specificity were 92.5% and 90.2%, respectively, the rate of accuracy was 88.9%; 2. Corresponding disappearance and diminution of abnormal isotopic concentration were observed in 41 symptom-controlled patients, the total concordance rate was 92.6%; 3. Positive isotopic accumulation was found in 15/16 relapsing patients, the concordant rate of clinical manifestations and isotopic findings being 91.6%. Conclusions: The ~(99m)Tc-hIgG scintigraphy is a highly sensitive, specific and adjuvant method in the diagnosis of inflammatory bowel diseases, which is also valuable in assessment of therapeutic efficacy and prediction of recurrence.