Aboughalia Hassan A, Cheeney Safia H E, Elojeimy Saeed, Blacklock Lisa C, Parisi Marguerite T
Department of Radiology, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
Department of Radiology, Seattle Children's Hospital, Seattle, WA, USA.
Pediatr Radiol. 2023 Mar;53(3):493-508. doi: 10.1007/s00247-022-05527-z. Epub 2022 Nov 3.
Meckel diverticulum, the most common congenital anomaly of the gastrointestinal tract, results from the aberrant involution of the omphalomesenteric duct and accounts for more than 50% of unexplained lower gastrointestinal bleeding in the pediatric population. The most accurate imaging tool to identify a Meckel diverticulum containing ectopic gastric mucosa is the Technetium-99m pertechnetate Meckel scan, a scintigraphic study with a reported accuracy of 90% in the pediatric population. In addition to depicting a Meckel diverticulum with ectopic gastric mucosa, careful attention to the normal biodistribution of the radiotracer can lead to the identification of unexpected pathology with implications for patient management. This article serves to review the embryological origin and anatomical features of Meckel diverticulum, highlight the role of scintigraphy in evaluating Meckel diverticulum, and discuss the proper imaging technique when performing this test. We will focus on pitfalls that can lead to an erroneous diagnosis as well as incidental findings that can affect patient management.
梅克尔憩室是胃肠道最常见的先天性异常，由卵黄管异常退化引起，在儿童不明原因下消化道出血中占比超过50%。识别含有异位胃黏膜的梅克尔憩室最准确的成像工具是锝-99m高锝酸盐梅克尔扫描，这是一项闪烁扫描研究，据报道在儿童人群中的准确率为90%。除了描绘含有异位胃黏膜的梅克尔憩室外，仔细关注放射性示踪剂的正常生物分布可发现意外病变，从而影响患者的管理。本文旨在回顾梅克尔憩室的胚胎起源和解剖特征，强调闪烁扫描在评估梅克尔憩室中的作用，并讨论进行此项检查时的正确成像技术。我们将重点关注可能导致错误诊断的陷阱以及可能影响患者管理的偶然发现。
