Elongated Appearance of Meckel’s Diverticulum on 99mTcO4 Scintigraphy

Wu, Ha; Zhao, Ruifang; Song, Zai; Kung, BT; Zhao, Xiao-fei

doi:10.1097/rlu.0000000000002127

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…Meckel's diverticulum is presented in scintigrams as a focus with elevated 99m Tc-pertechnetate activity, typically seen at the right lower quadrant of the abdomen. 1,9 While the above description is compatible with most MD cases, there is still a high chance of ignoring an atypical presentation. In a retrospective cohort of 93 patients with positive Meckel scan and complete surgical record, it was discovered that 10.8% of MD patients have an atypical scintigram, whereby the lesion is located at the right abdominal upper quadrant.…”

Section: Discussionmentioning

confidence: 68%

“…In a retrospective cohort of 93 patients with positive Meckel scan and complete surgical record, it was discovered that 10.8% of MD patients have an atypical scintigram, whereby the lesion is located at the right abdominal upper quadrant. 9 An atypical planar Meckel scan image is generally more difficult to interpret because it could overlap with other organs and structures with normal physiological uptake patterns. 8 In children, the blood disappearance rate of radioactive pertechnetate could be prolonged due to renal immaturity.…”

Section: Discussionmentioning

confidence: 99%

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Practical advantage of SPECT/CT image co-registration for accurate bleeding Meckel’s diverticulum localization in pediatrics: A case report

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Lee

et al. 2021

Proceedings of Singapore Healthcare

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Planar scintigraphy with 99mTc-pertechnetate or Meckel scan is the gold standard in the diagnosis of a bleeding Meckel’s diverticulum (MD) for pediatrics. However, several setbacks may occur during the interpretation of a scintigram, especially in cases of an atypical MD presentation. In this report, we highlight the importance of functional and anatomical image co-registration using a hybrid SPECT/CT scanner to precisely localize a MD lesion. An 18-month-old boy presented with severe hematochezia over 4 days with declining hemoglobin levels. He underwent a conventional 60-min dynamic planar imaging of the Meckel scan. Upon review of the Meckel scan, a suspicious increase in the 99mTc-pertechnetate uptake was observed at the right upper quadrant of the abdomen. Due to its atypical location at the right kidney, we could not differentiate between a physiological uptake of the right kidney or an ectopic gastric mucosa. The patient was imaged again using single-photon emission computed tomography (SPECT) and low-dose CT protocol with a hybrid SPECT/CT scanner, and the co-registration of both SPECT and CT images was able to confirm the MD, which was located anterior to the right kidney at the right hepatic flexure region. An exploratory laparotomy was then ensued to remove the bleeding MD. The patient was discharged after 3 days with no complications. In summary, this case illustrates that hybrid imaging modality and co-registration allow for a more definitive diagnosis, as well as a more precise localization of MD.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%