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【目的】评价小儿异位胃粘膜99mTcO4-显像的临床诊断价值,对临床诊断提供参考依据。【方法】94例下消化道出血(疑异位胃粘膜)患者进行了99mTcO4-显像,显像资料均参照临床最终结果进行评价。【结果】94例患者中显像阳性者32例,其中29例证实为麦克尔憩室,2例为小肠重复畸形,1例为空肠粘膜下血管畸形。显像阴性62例,可追踪住院病例28例,经手术及胃、肠镜证实胃溃疡或肠息肉8例,1例麦克尔憩室,其余病例根据临床表现和治疗好转出院排除胃粘膜异位症9。9mTcO4-显像诊断异位胃粘膜的灵敏度为96.9%,特异度为96.4%,准确度为96.7%。【结论】小儿异位胃粘膜核素显像具有较高的诊断价值,且无创、简单易行、快速可靠,是临床诊断异位胃粘膜首选的影像学方法。
【Objective】 To evaluate the clinical value of 99mTcO4- imaging in children with heterotopic gastric mucosa and to provide reference for clinical diagnosis. 【Methods】 Ninety-four patients with lower gastrointestinal bleeding (suspected gastric mucosa) underwent 99mTcO4-imaging. The imaging data were evaluated with reference to the final clinical results. 【Results】 Among the 94 patients, 32 were imaging positive, of which 29 were confirmed as Meckel diverticulum, 2 were small intestine deformity and 1 was jejunal submucosal vascular malformation. Imaging negative 62 cases, 28 cases can be traced to hospitalization, confirmed by surgery and stomach, colonoscopy confirmed gastric ulcer or intestinal polyps in 8 cases, 1 case of Michael diverticulum, the remaining cases based on clinical manifestations and treatment of patients discharged to rule out gastric mucosal dysplasia 9.9mTcO4-imaging diagnosis of ectopic gastric mucosa sensitivity was 96.9%, specificity was 96.4%, accuracy was 96.7%. 【Conclusion】 Pediatric heterotopic gastric mucosal radionuclide imaging has a high diagnostic value and is noninvasive, simple, rapid and reliable. It is the first imaging method for clinical diagnosis of ectopic gastric mucosa.