Area Editoriale
Assessingthe extent of ulcerative colitis determines therapeutic strategies and providesprognostic information. Colonoscopy with mucosal biopsy is considered unsafe inpatients with severe disease. Aim To assess the correlation between proximalextent of ulcerative colitis as determined by Technitium-99-mhexamethylpropylene amine oxime labelled leucocyte scan (white cell scan) withthat determined by histological assessment. Methods One hundred and thirty-fivepatients, with histologically-confirmed ulcerative colitis, who had a whitecell scan and histological assessment of colonic inflammation within 6 monthsof each other, during the years 1991-2004, were included. Overall agreement,quadratic-weighted kappa (κ) and polychoric correlations (ρ) were calculated toestimate the inter-rater reliability. ResultsThecorrelation between white cell scan and histological extent was excellent (κ =0.7 ρ = 0.8). Macroscopic appearance on colonoscopy did not correlate as wellwith histological extent (κ = 0.62 and ρ = 0.67). White cell scans correlatedsignificantly better in patients with extensive disease (P = 0.02). Colonoscopypredicted disease extent more accurately in patients with limited colitis (P =0.002).ConclusionsProximalextent of ulcerative colitis determined by white cell scans correlates wellwith histological assessment especially in patients with more extensivedisease. White cell scans offer a reasonable alternative to colonoscopy withmucosal biopsies in determining the proximal extent of colitis.Leggil'articolo