Li Bo, Gao Jian, Ding Xintao, Li Xiali, Yu Yue, Long Ye, Wang Xiaohui, Wu Xinyu, Gao Yongju
Department of Nuclear Medicine, Henan Key Laboratory of Novel Molecular Probes and Clinical Translation in Nuclear Medicine, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, China.
Department of Pediatric Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, China.
Front Med (Lausanne). 2025 May 21;12:1585313. doi: 10.3389/fmed.2025.1585313. eCollection 2025.
To assess the diagnostic accuracy of [ Tc]pertechnetate scintigraphy in pediatric patients with suspected Meckel's diverticulum (MD).
A retrospective study was conducted on 94 pediatric patients who presented with symptoms suggestive of MD and underwent [ Tc]pertechnetate scintigraphy at Henan Provincial People's Hospital between September 2012 and August 2024. For patients with high clinical suspicion and equivocal scintigraphy results, Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) or repeat scintigraphy was conducted. Hemoglobin levels were measured in all patients, and their correlation with MD was analyzed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated by comparing scintigraphic results with surgical and histopathological findings.
Among the 94 patients, 20 (21.3%) had positive [ Tc]pertechnetate scintigraphy, all confirmed as true positives through laparoscopic resection and histopathological examination. Of the 74 patients with negative scintigraphy results, 6 were found to be false negatives based on surgical findings, and 68 were confirmed as true negatives. Therefore, the sensitivity, specificity, PPV, and NPV were 76.9% (20/26), 100.0% (68/68), 100.0% (20/20), and 91.9% (68/74), respectively. The overall diagnostic accuracy was 93.6% (88/94). SPECT/CT was utilized in three cases, enhancing diagnostic precision in patients with equivocal planar imaging results. Repeat scintigraphy was performed in three patients with high clinical suspicion and negative initial scans, resulting in one additional positive diagnosis. MD patients exhibited significantly lower hemoglobin levels compared to non-MD patients (88.69 ± 20.39 g/L vs. 107.24 ± 29.28 g/L; = 0.0009), with hemoglobin showing moderate predictive value (AUC = 0.70; 95% CI: 0.60-0.81).
[ Tc]pertechnetate scintigraphy is a highly specific and accurate tool for diagnosing MD in pediatric patients. However, due to the potential for false negatives, additional SPECT/CT imaging or repeat scintigraphy may be warranted in cases with high clinical suspicion.
评估[锝]高锝酸盐闪烁扫描术对疑似梅克尔憩室（MD）患儿的诊断准确性。
对2012年9月至2024年8月期间在河南省人民医院就诊、有MD疑似症状并接受[锝]高锝酸盐闪烁扫描术的94例患儿进行回顾性研究。对于临床高度怀疑且闪烁扫描结果不明确的患者，进行单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）或重复闪烁扫描。测量所有患者的血红蛋白水平，并分析其与MD的相关性。通过将闪烁扫描结果与手术及组织病理学结果进行比较，计算敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）及总体诊断准确性。
94例患者中，20例（21.3%）[锝]高锝酸盐闪烁扫描结果为阳性，均通过腹腔镜切除及组织病理学检查确诊为真阳性。闪烁扫描结果为阴性的74例患者中，6例根据手术结果为假阴性，68例确诊为真阴性。因此，敏感性、特异性、PPV及NPV分别为76.9%（20/26）、100.0%（68/68）、100.0%（20/20）及91.9%（68/74）。总体诊断准确性为93.6%（88/94）。3例患者使用了SPECT/CT，提高了平面成像结果不明确患者的诊断精度。3例临床高度怀疑且初次扫描为阴性的患者进行了重复闪烁扫描，新增1例阳性诊断。MD患者的血红蛋白水平显著低于非MD患者（88.69±20.39 g/L对107.24±29.28 g/L；P = 0.0009），血红蛋白显示出中度预测价值（AUC = 0.70；95%CI：0.60 - 0.81）。
[锝]高锝酸盐闪烁扫描术是诊断小儿MD的一种高度特异性和准确性的工具。然而，由于存在假阴性的可能性，对于临床高度怀疑的病例，可能需要额外的SPECT/CT成像或重复闪烁扫描。
