小儿消化道出血99Tcm-高锝酸盐对异位胃黏膜显像的特征

目的：研究小儿消化道出血^99Tc^m－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141例消化道出血患儿作了^99Tc^m－高锝酸盐异位胃黏膜显像，按7．4MBq/kg静脉注射^99Tc^m－高得锝酸盐，以脐为中心进行动态17min和静态30min或1h的采集。结果：141例患儿中59例显像阳性，阳性检出率为41．8％。141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22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2．08％（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^99Tc^m－高锝酸盐异位胃黏膜显像中，有特征性影像学表现。

Image Characteristics of Ectopic Gastric Mucosa's 99Tcm-pertechnetate Scintigraphy in Pediatric Patients with Gastrointestinal Bleeding

Objective To study the image characteristics of ectopic gastric mucosa's ⁹⁹Tc^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 ⁹⁹Tc^m-pertechnetate scintigraphy was undertaken in 141 children with gastrointestinal bleeding. ⁹⁹Tc^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 ⁹⁹Tc^m-pertechnetate scintigraphy, the image of meckel's divercticulum and small intestinal duplication are characteristics, respectively.