^(99m)TcO4异位胃黏膜显像对儿童梅克尔憩室的诊断价值

Diagnostic value of ^(99m)TcO4 ectopic gastric mucosa imaging in children with Meckel's diverticulum

目的评价99m高锝酸盐(99mTcO4)异位胃黏膜显像对儿童梅克尔憩室的诊断价值。方法对34例下消化道出血疑诊为梅克尔憩室的患儿行99mTcO4异位胃黏膜显像,对显像结果与临床最终诊断结果进行比较。结果 34例患儿中,阴性显像13例,均排除梅克尔憩室。阳性显像21例,病变在右下腹的患儿15例,经手术病理证实为梅克尔憩室;病变在右下腹以外部位6例均为假阳性,经外科或内窥镜等检查证实其中3例为肠溃疡,1例为刺伤,2例病因未明。99mTcO4异位胃黏膜显像诊断梅克尔憩室的灵敏度、特异性、阳性预测值及阴性预测值分别为100.00%、82.35%、71.43%和100.00%;特别对于右下腹阳性显像病例,其灵敏度、特异性、阳性预测值均达到100.00%。结论 99mTcO4异位胃黏膜显像是一种无创、有效和简单易行的诊断儿童梅克尔憩室的首选影像学方法,特别对于显像阳性部位在右下腹的患儿,具有更高的诊断价值。

Objective To assess the diagnostic value of 99mTcO4 ectopic gastric mucosa imaging in children with Meckel＇s diverticulum.Methods 99mTcO4 ectopic gastric mucosa imaging was performed in 34 children with a history of gastrointestinal bleeding（suspected to be Meckel＇s diverticulum）.The materials were evaluated according to final clinical results.Results Of 34 cases,13 cases had negative imaging,who were found to be without Meckel＇s diverticulum finally.The rest 21 cases had positive imaging,in whom the lesions located in the right lower quarter and Meckel＇s diverticulum was proved by surgery in 15 cases.The lesions of other 6 cases located out of the right lower were all false positive by surgery and endoscopy or other methods,in whom intestinal ulcers were diagnosed in 3 cases,surgery lesion in 1 case and no definite diagnose in 2 cases.The sensitivity,specificity,positive and negtive predictive value of 99mTcO4 ectopic gastric mucosa imaging were 100%,82.35%,71.43% and 100%.The sensitivity,specificity and positive predictive value of that were all 100% for the lesions located in the right lower quarter.Conclusion 99mTcO4 ectopic gastric mucosa imaging is a non-invasive,effective and simple imaging examination,which should be the first choice in the diagnosis of Meckel＇s diverticulum,especially for the lesions located in the right lower quarter in children.