Small bowel Crohn's disease: comparison of enteroclysis, bowel sonography and Tc-99m-HMPAO leukocyte scintigraphy.

BACKGROUND: Crohn's disease (CD) frequently involves the small bowel. Actually, the diagnosis of CD is made by ileocolonoscopy (IC) and small bowel enteroclysis (SBE), while trans-abdominal bowel sonography (BS) and Tc-99m-HMPAO leukocyte scintigraphy (LS) are only partially used in spite of their minimal invasiveness. AIM: to compare the diagnostic accuracy of these procedures for the diagnosis of small bowel CD. PATIENTS AND METHODS: in about two years a series of consecutive subjects underwent IC, SBE, BS and LS for either suspected or known small bowel CD. RESULTS: Sensitivity, specificity, positive and negative predictive value for CD diagnosis of the studied procedures were respectively: 98%, 97%, 98% and 97% for SBE; 92%, 97%, 98%, and 88% for BS; 90%, 93%, 96% and 85% for LS. In addition, the parallel combined use of BS and LS led to overall sensitivity, specificity, positive and negative predictive value of 100%, 93%, 96%, 100%, respectively. CONCLUSION: SBE, BS and LS are accurate procedures for the diagnosis of small bowel Crohn's disease. The use of BS and LS, particularly in combination, can be proposed as early diagnostic approach to subjects with a suspicion of disease.