目的：评价99mTcO4-胃黏膜异位核素显像诊断儿童梅克尔憩室的临床价值。方法回顾性分析95例消化道出血患儿99mTcO4-显像，手术及病理组织学检查结果。结果95例患儿行99mTcO4-核素检查发现梅克尔憩室44例，检出率为46.3%；其中诊断胃黏膜小肠异位52.3%(23/44)，疑诊胃黏膜小肠异位47.7%(21/44)；男∶女为7.8∶1。37例核素显像阳性者行手术治疗，其中35例术中见梅克尔憩室，1例术中见肠重复畸形，1例术中未发现憩室病变。35例术中见梅克尔憩室患儿的病理诊断均为梅克尔憩室、胃黏膜上皮异位，其中2例伴溃疡形成，1例伴小片胰腺组织，1例伴回盲部化脓性肠炎，1例伴慢性阑尾炎。结论99mTcO4-显像可作为儿童梅克尔憩室首选的无创伤性检查方法，具有重要的临床诊断价值。%Objective To evaluate the accuracy of 99mTcO4- gastrointestinal imaging in the diagnosis of Meckel’s diverticulum in children. Methods The clinical data of 99mTcO4-imaging, surgery and pathological results of 95 children with gastrointestinal bleeding were retrospectively analyzed. Results Forty-four cases of 95 patients had positive ifnding of 99mTcO4-ectopic gastric mucous membrane imaging, and positive rate was 46.3%. In the positve cases 52.3%cases (23/44) were diagnosed of intestinal heterotopic gastric mucosa, 47.7%cases (21/44) were suspected of intestinal heterotopic gastric mucosa. The sex ratio (males to females) was 7.8:1. Thirty-seven positive cases underwent operation;among them, 35 cases were found to have Meckel’s diverticulum and 1 case had duplication of the digestive tract;Diverticulum lesion was not found in 1 case. The samples of 35 cases diagnosed surgically of Meckel’s diverticulum were examined by pathologic histology. All 35 cases were conifrmed as Meckel’s diverticulum and ectopic gastric mucosa epithelium, including 2 cases with ulcer formation, 1 case with small patches of pancreatic tissue, 1 case with ileocecal junction of suppurative enteritis and 1 case with chronic appendicitis. Conclusions 99mTcO4-radionuclide imaging technique is of high value for the non-invasive diagnosis of children’s Meckel’s diverticulum.
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