^(99m)TcO_(4)-异位胃黏膜显像可作为儿童梅克尔憩室的诊断工具

^(99m)TcO_(4)-ectopic gastric mucosal imaging can be used for the diagnosis of Meckel's diverticulum in children

目的探讨^(99m)TcO_(4)-异位胃粘膜显像在儿童梅克尔憩室诊断中的临床价值。方法通过对2017年1月~2022年1月因便血、肠梗阻等症状就诊于兰州大学第二医院的39例临床疑似梅克尔憩室的儿童进行回顾性分析,包括基本信息、血常规、^(99m)TcO_(4)-异位胃粘膜显像、腹部超声和手术病理结果。结果39例患儿中,25例经手术证实为梅克尔憩室。^(99m)TcO_(4)-异位胃粘膜显像诊断敏感度为64.00%,特异性为92.31%,阳性预测值为94.12%,诊断准确率为71.79%。梅克尔憩室组血红蛋白、红细胞均低于非梅克尔憩室组(P<0.05)。将梅克尔憩室组根据手术前^(99m)TcO_(4)-异位胃粘膜显像的结果分为真阳性组(n=16)与假阴性组(n=9),真阳性组血红蛋白、红细胞、白细胞均低于假阴性组;真阳性组病灶最大径大于假阴性组;经病理证实真阳性组均存在异位胃粘膜,假阴性组6例存在异位胃粘膜,两组间是否存在异位胃粘膜组织的差异有统计学意义(P<0.05)。结论^(99m)TcO_(4)-异位胃粘膜显像对儿童梅克尔憩室的诊断具有重要价值,但受多种因素影响。

Objective To explore the clinical value of^(99m)TcO_(4)-ectopic gastric mucosa imaging in the diagnosis of Meckel's diverticulum in children.Methods A retrospective analysis was conducted on thirty-nine children with clinical suspicion of Meckel's diverticulum who were admitted to the Second Hospital of Lanzhou University from January 2017 to January 2022 due to symptoms such as hematochezia and intestinal obstruction.Basic information,blood routine,^(99m)TcO_(4)-ectopic gastric mucosa imaging,abdominal ultrasound and surgical pathological results were included.Results Among the thirty-nine children,twenty-five were confirmed to have Meckel's diverticulum through surgery.The diagnostic sensitivity of^(99m)TcO_(4)-ectopic gastric mucosa imaging was 64.00%,the specificity was 92.31%,the positive predictive value was 94.12%,and the diagnostic accuracy was 71.79%.The hemoglobin and red blood cell in the Meckel's diverticulum group were significantly lower than those in the non-Meckel's diverticulum group(P<0.05).The Meckel's diverticulum group was divided into the true positive group(n=16)and the false negative group(n=9)based on the results of^(99m)TcO_(4)-ectopic gastric mucosa imaging before surgery.The hemoglobin,red blood cell and white blood cell counts in the true positive group were significantly lower than those in the false negative group;the maximum diameter of the lesion in the true positive group was significantly larger than that in the false negative group;pathologically confirmed that all patients in the true positive group had ectopic gastric mucosa,and 6 patients in the false negative group had ectopic gastric mucosa.There was a statistically significant difference in the presence of ectopic gastric mucosa tissue between the two groups(P<0.05).Conclusion^(99m)TcO_(4)-ectopic gastric mucosal imaging holds significant diagnostic value for Meckel's diverticulum in children,although its accuracy is influenced by various factors.