Koç Zehra Pınar, Özcan Pınar Pelin, Tuncel Ferah, İsbir Caner, Usta Yusuf
Department of Nuclear Medicine, Mersin University, Mersin, Türkiye.
Department of Pathology, Mersin University, Mersin, Türkiye.
World J Nucl Med. 2024 Jun 11;23(3):176-179. doi: 10.1055/s-0044-1787719. eCollection 2024 Sep.
The imaging of Meckel's diverticulum (MD) is based of accumulation of Tc-99m pertechnetate in the ectopic gastric mucosa (EGM) content. Although the diagnostic accuracy of this imaging modality is high, there are some overlap patients with coexisting gastrointestinal bleeding and false positive causes hampering diagnostic power. The aim of this study was to evaluate the possible contribution of single-photon emission computed tomography/computed tomography (SPECT/CT) in EGM-MD diagnosis and to determine the indication of this additional imaging modality. Fifty-two pediatric patients (24 girls, 28 boys; mean age: 8.06 ± 5.22 years old) who have suspicion of MD and referred for scintigraphy were evaluated retrospectively. Additional SPECT/CT were performed to selected five cases among the group. The results of the scintigraphy as well as SPECT/CT were compared with endoscopy, pathology, and/or follow-up results. There were 9 patients with equivocal study results, 12 positive results, and the others were considered negative MD scintigraphy. One patient was out of follow-up and 10 patients underwent surgery. Only one single patient was negative during surgery but scintigraphy was also negative. The diagnostic sensitivity, specificity, and accuracy were 100, 95, and 96%, respectively. Among five patients with SPECT/CT results one patient was diagnosed by only SPECT/CT who had EGM in duplication cyst, one equivocal patient was diagnosed as descending colon bleeding, and one patient's lesion was clearly delineated by SPECT/CT. SPECT/CT has clear advantage over standard planar scintigraphy imaging in EGM-MD determination. This modality might decrease equivocal and false positive results but this issue has to be addressed with further studies.
梅克尔憩室（MD）的成像基于锝-99m高锝酸盐在异位胃黏膜（EGM）中的聚集。尽管这种成像方式的诊断准确性较高，但仍有一些同时存在胃肠道出血的重叠患者以及导致假阳性的原因，从而影响了诊断能力。本研究的目的是评估单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）在EGM-MD诊断中的可能作用，并确定这种额外成像方式的适应证。 对52例疑似MD并转诊进行闪烁扫描的儿科患者（24例女孩，28例男孩；平均年龄：8.06±5.22岁）进行回顾性评估。在该组中选择5例患者进行额外的SPECT/CT检查。将闪烁扫描以及SPECT/CT的结果与内镜检查、病理检查和/或随访结果进行比较。 闪烁扫描结果不明确的患者有9例，阳性结果12例，其他患者闪烁扫描结果为MD阴性。1例患者失访，10例患者接受了手术。手术中仅1例患者为阴性，但闪烁扫描结果也为阴性。诊断敏感性、特异性和准确性分别为100%、95%和96%。在5例有SPECT/CT结果的患者中，1例仅通过SPECT/CT诊断出重复囊肿中有EGM，1例结果不明确的患者被诊断为降结肠出血，1例患者的病变通过SPECT/CT清晰显示。 在EGM-MD的判定中，SPECT/CT比标准平面闪烁扫描成像具有明显优势。这种方式可能会减少不明确和假阳性结果，但这个问题有待进一步研究解决。
