Is scintigraphic double-track appearance a sign of severe acute episodes of ulcerative colitis?

Summary Aim In comparison to endoscopy, clinical and biological criteria are less predictive of severity in attacks of ulcerative colitis (UC). Our aim was to assess the value of the double-track scintigraphic appearance in the assessment of the severity of acute UC by comparing it to endoscopic criteria. Patients and methods We reviewed medical records of 52 patients hospitalized for an acute attack of UC, who had undergone within 48 hours of presentation both a technetium 99m hexamethyl propylene amine oxime ( 99m Tc-HMPAO) granulocyte scintigraphy and endoscopic examination (colonoscopy: n=20; rectosigmoidoscopy: n=32). Results Taking into account the colonic segments examined together with both methods in the same patient or results obtained with colonoscopies, there was an excellent agreement between the double-track scintigraphic appearance and endoscopic criteria of severity. Conclusion In patients with previously diagnosed UC, 99m Tc-HMPAO granulocyte scintigraphy when available may replace endoscopic examination to assess the severity of attacks.