Schwartz M J, Lewis J H
Am J Gastroenterol. 1984 Aug;79(8):611-8.
The diagnosis of a bleeding Meckel's diverticulum containing ectopic gastric mucosa by 99m-Tc pertechnetate imaging is reported to have a diagnostic accuracy of 90% for patients in the pediatric age group. The usefulness of Meckel's scanning in adults is, however, less certain. We present two patients who illustrate some of the difficulties inherent in Meckel's scanning in adults; one had a false-negative scan despite the presence of ectopic gastric mucosa and the other had a false-positive scan, both confirmed by laparotomy. The available literature indicates that false-positive and false-negative scans occur relatively frequently in adults, but no comprehensive review on this subject exists. Based on our findings, it is suggested that Meckel's scanning be supplemented with small bowel infusion or arteriography or both to improve preoperative diagnosis in adult patients in whom a diverticulum is suspected.
据报道，通过99m锝高锝酸盐成像诊断含有异位胃黏膜的出血性梅克尔憩室，对于儿童年龄组患者的诊断准确率为90%。然而，梅克尔扫描在成人中的实用性尚不确定。我们介绍两名患者，他们说明了成人梅克尔扫描中固有的一些困难；一名患者尽管存在异位胃黏膜，但扫描结果为假阴性，另一名患者扫描结果为假阳性，两者均经剖腹手术证实。现有文献表明，成人中假阳性和假阴性扫描相对频繁发生，但尚无关于该主题的全面综述。根据我们的研究结果，建议对疑似憩室的成年患者，补充小肠灌注或血管造影或两者兼用以改善术前诊断。
