不同采集法对异位胃黏膜核素显像诊断小儿梅克尔憩室的影响  

To Investigate the Influence of the Diagnosis of Meckel's Diverticulum in Ectopic Gastic Mucosa Imaging by Different Acquisition Methods

作　　者：彭鸣亚[1] 赵骏[1] 薛卫红[1] 栾玉芬[1] 

机构地区：[1]南京医科大学附属常州市第二人民医院核医学科,江苏常州213003

出　　处：《中国继续医学教育》2016年第36期32-33,共2页China Continuing Medical Education

摘　　要：目的探讨不同采集方法对梅克尔憩室检出率的影响。方法对有腹痛、便血史,临床怀疑梅克尔憩室者的25例患者行^(99mTc)O_4^-异位胃黏膜显像,显像前禁食8 h以上,依据不同采集方法将患儿分为A组:动态采集法,受检者仰卧位,探头置于腹部上方,视野包括上腹部和下腹部,剂量按200~300 mci/kg计算,"弹丸"式静脉注射显像剂后立刻行动态显像,矩阵64×64,每帧2 s,采集32帧,之后每帧1 min,共采集60 min。B组:静态采集法:体位、注射剂量、视野等与动态采集法无异,矩阵为64×64,于注射后1 min、5 min、10min、15 min、20 min、30 min、40 min、50 min、60 min各采集1帧,采集计数每帧1 M。不同方法显像结果与临床最终诊断结果进行对比、评价、分析。结果 A组11例患者有3例为阳性显像,最终经病理确诊梅克尔憩室3例,检出率为27.27%,B组14例患者有4例为阳性显像,最终经病理确诊为梅克尔憩室4例,检出率为28.57%,检出率差异无统计学意义(P>0.05)。结论静态采集法是一种更有效简便的检查方法,对年龄偏低、反复出血、病情严重的患儿尤其适用。Objective To investigate the different methods of collection effect on the recovery rate of Meckel’s diverticulum. Methods In collection of 25 cases of patients which have the history of abdominal pain, hematochezia, clinical suspicion of Meckel’s diverticulum. Using the method of 99mTcO4- ectopic gastric mucosa imaging, fasting for 8h before imaging, and according to the different collection methods, which were divided into two group. A： dynamic sampling method, a probe is in the top of the abdomen which in the supine position, including vision on the abdomen and lower abdomen, the dose calculated by 200300 mci/kg, execute the dynamic imaging immediately after the ＂bullet＂ injection, 64×64 matrix, each frame is 2 s, collecting 32 frames, each frame after 1 min, all 60 min. B： static sampling method, 64×64, collect 1 frames after injection, 1 min, 5 min, 10 min, 15 min, 20 min, 30 min, 40 min, 50 min, 60 min, per frame is 1 M. With the final clinical diagnosis results were compared and analyzed. Results Among the 11 cases of group A, 3 cases of ectopic gastic mucosa imaging were positive, the dectetion rate was 27.27%, among the 14 cases of group B, 4 cases of ectopic gastic mucosa imaging were positive, the final pathological diagnosis of Meckel’s diverticulum in 4 cases, the dectetion rate was 28.57%. There are no significant diffewrence in dectetion rate of Meckel’s diverticulum between the two groups（P〉0.05）, all diagnosis results were confirmed by surgery and pathological examination. Conclusion The ectopic gastic mucosa imaging by static acquisition method was more convenient and effective in the diagnosis of astrointestinal bleeding in children.

关 键 词：梅克尔憩室 儿童 放射性核素 

分 类 号：R726.5[医药卫生—儿科]