Kiratli Pinar O, Aksoy Tamer, Bozkurt Murat F, Orhan Diclehan
Department of Nuclear Medicine, Hacettepe University, Medical Faculty, 06100 Sihhiye, Ankara, Turkey.
Ann Nucl Med. 2009 Feb;23(2):97-105. doi: 10.1007/s12149-008-0204-6. Epub 2009 Feb 19.
Technetium-99m ((99m)Tc) pertechnetate scintigraphy in a child with acute gastrointestinal bleeding of unknown origin suggests ectopic gastric mucosa caused by Meckel's diverticulum or gastrointestinal duplication cysts. Our objective was to define the patterns of scintigraphic findings likely to be encountered in patients with ectopic gastric mucosa with illustrative cases and to review the literature. Fifty children (age 1 year to 14 years) were evaluated for ectopic gastric mucosa using (99m)Tc pertechnetate scintigraphy. Functioning ectopic gastric mucosa was detected in eight patients with Meckel's diverticula and three patients with bowel duplication. Three patients showed atypical findings on scintigraphy which were perforated appendix, calyceal stasis, and regional enteritis. Ectopic functioning gastric mucosa in Meckel's diverticulum is visualized simultaneously with the stomach, whereas in intestinal duplications tracer activity can be visualized in the dynamic sequence or before gastric tracer visualization in an irregular pattern. A variety of scintigraphic patterns can be found in patients with ectopic gastric mucosa undergoing (99m)Tc pertechnetate scintigraphy depending on the location and size of the ectopic tissue. Also, acquisition of delayed images is useful when the initial images are equivocal in children.
锝-99m（99mTc）高锝酸盐闪烁扫描术用于一名不明原因急性胃肠道出血儿童时，提示梅克尔憩室或胃肠道重复囊肿所致的异位胃黏膜。我们的目的是通过实例病例明确异位胃黏膜患者可能出现的闪烁扫描结果模式，并回顾相关文献。对50名年龄在1岁至14岁的儿童进行了99mTc高锝酸盐闪烁扫描术以评估异位胃黏膜。在8例梅克尔憩室患者和3例肠重复患者中检测到功能性异位胃黏膜。3例患者在闪烁扫描时表现出非典型结果，分别为阑尾穿孔、肾盏淤滞和局限性肠炎。梅克尔憩室中的异位功能性胃黏膜与胃同时显影，而在肠重复畸形中，示踪剂活性可在动态序列中显影，或在胃示踪剂显影之前以不规则模式显影。接受99mTc高锝酸盐闪烁扫描术的异位胃黏膜患者，根据异位组织的位置和大小，可发现多种闪烁扫描模式。此外，当儿童的初始图像不明确时，采集延迟图像是有用的。
