梅克尔憩室术前诊断方法比较分析

Comparative analysis of the preoperative diagnosis of Meckel diverticulum

目的通过比较分析梅克尔憩室(Meckeldiverticulum,MD)的不同术前诊断方法,评价各方法在术前诊断MD的检出率及优缺点。方法回顾性分析海军军医大学第一附属医院2005年8月至2020年4月收治的9例诊断为MD患者的临床表现、影像学及内镜检查结果。结果本资料中,异位胃黏膜核素显像术前检出率为100%;小肠镜术前检出率为25%;而腹部B超、X线平片、CT平扫、小肠增强CT三维重建、全消化道造影及胶囊内镜检查在术前均不易得出MD诊断。结论与其他检查方法相比较,异位胃黏膜核素显像具有无创、低辐射、检出率高等优点。对于高度怀疑为MD的患者应尽早行异位胃黏膜核素显像,以提高该疾病的术前诊断率。

Objective To evaluate the detection rate,advantages and disadvantages of various methods for preoperative diag⁃nosis of Merkel diverticulum through analyzing the preoperative diagnosis methods of the disease.Methods Retrospective analysis was made regarding the clinical manifestations,imaging and endoscopic results of the 9 cases diagnosed as Merkel diverticulum from August 2005 to April 2020.Results The study showed the preoperative detection rate by gastric mucosal radionuclide imaging was 100%,while the preoperative detection rate by enteroscopy was just 25%.Before surgery,abdominal ultrasound,X⁃ray plain film,com⁃puted tomography(CT),three⁃dimensional reconstruction of the enhanced CT of the small intestine,and total gastrointestinal angiogra⁃phy were difficult to obtain sure diagnosis of Merkel diverticulum.Conclusion Compared with other detection methods,ectopic gas⁃tric mucosal radionuclide imaging has the advantages of non⁃invasion,low radiation and high detection rate.To those patients highly suspected of Merkel diverticulum,ectopic gastric mucosal radionuclide imaging should be performed as early as possible,so as to im⁃prove the preoperative diagnosis rate of the disease.