小儿消化道出血^(99)Tc^m高锝酸盐对异位胃黏膜显像的特征

Image Characteristics of Ectopic Gastric Mucosa's ^(99)Tc^m-pertechnetate Scintigraphy in Pediatric Patients with Gastrointestinal Bleeding

目的 研究小儿消化道出血99Tcm 高锝酸盐异位胃黏膜的显像特征 ,建立美克尔憩室和小肠重复畸形影像学的诊断标准。方法 对 14 1例消化道出血患儿作了99Tcm 高锝酸盐异位胃黏膜显像 ,按 7.4MBq/kg静脉注射99Tcm 高锝酸盐 ,以脐为中心进行动态 17min和静态 30min或 1h的采集。结果 14 1例患儿中 5 9例显像阳性 ,阳性检出率为 41.84%。 14 1例消化道出血中 ,经手术和病理证实了 48例。其中美克尔憩室 18例 ,形态呈小圆形或近似小圆形 1～ 3cm的异常浓集区。小肠重复畸形 2 2例 ,其中呈条索肠袢状 12例 ,团块状 5例 ,4cm以上大圆形异常浓集区 4例。食管、胃重复畸形 3例。在 48例患儿中 ,假阴性率为 2 .0 8% (小肠重复畸形 1例 ) ,假阳性 5例 ,为 10 .42 %。结论 美克尔憩室与小肠重复畸形在 99Tcm 高锝酸盐异位胃黏膜显像中 。

Objective To study the image characteristics of ectopic gastric mucosa's 99 Tc m pertechnetate scintigraphy in gastrointestinal bleeding children, and establish the diagnoses standard of Meckel's diverticulum and small intestinal duplication. Methods Ectopic gastric mucosa's 99 Tc m pertechnetate scintigraphy was undertaken in 141 children with gastrointestinal bleeding. 99 Tc m pertechnetate (7.4MBq/kg) was injected intravenously. Seventeen minutes dynamic and 30 minutes or one hour static acquistion were performed with umbilicus as the detecting center. Results Fifty nine cases of 141 patients were positive, and positive rate was 41.84%. Among all patients, 48 cases were confirmed by surgery and pathology. There were 18 Meckel's diverticulums which showed as little circular or similar little circular abnormal accumulations with diameter about 1～3cm, and 22 cases were small intestinal duplications, of these, 12 cases showed as bands like intestines. Five cases showed masses of accumulation, 4 cases showed large circular accumulations whose diameter were more than 4cm, and 3 duplications of oesophagus or stomach. In all cases, false negative rate was 2.08% (one image showed as intestinal duplication) and false positive were 5 cases (10.42%). Conclusion In ectopic gastric mucosa's 99 Tc m pertechnetate scintigraphy, the image of meckel's divercticulum and small intestinal duplication are characteristics, respectively.