拟诊美克耳憩室患儿腹部核素显像分析

美克耳憩室是婴幼儿下消化道出血最常见的原因 ,症状严重者 ,需手术治疗。但术前对美克耳憩室的诊断较为困难。本文对腹痛、消化道出血拟诊为美克耳憩室 12例进行了腹部放射性核素显像 ,并与手术及病检结果对照 ,探讨其对美克耳憩室的诊断价值。1　对象和方法1.1　对象　本组男 7例 ,女 5例 ,年龄 11月龄～ 13岁 ,平均 4 .2岁。临床症状为便血和腹痛 ,核素显像后均进行了手术和病理检查。1.2　方法　检查当日禁食水 ,静脉注射 99m Tc O- 4111～ 185 MBq后 5、15、30、4 5、6 0 min卧位采集腹部前位图像 ,必要时加侧位图像。仪器为美国 Ome…     

对比实时超声与核素显像诊断儿童美克尔憩室

目的 对比观察实时超声与核素显像诊断儿童美克尔憩室的价值。方法 收集临床拟诊为美克尔憩室或因其并发症而接受外科手术治疗的156例患儿,行实时超声检查和⁹⁹Tc^m-高锝酸盐腹部平面显像。以手术病理结果作为金标准,比较两种检查方法的诊断价值。结果 156例中,105例经病理检查证实为美克尔憩室。超声诊断美克尔憩室的敏感度、特异度和准确率为87.62%（92/105）、88.24%（45/51）和87.82%（137/156）,核素显像为71.43%（75/105）、72.55%（37/51）和71.79%（112/156）,超声均高于核素显像。结论 超声诊断儿童美克尔憩室及其并发症准确率较高,可作为临床诊断美克尔憩室的首选辅助方法。     

美克尔憩室并发出血一例分析

美克尔憩室是由于胚胎时期卵黄管退化不全引起的消化道畸形,常合并有消化道出血、梗阻、穿孔、憩室炎等并发症,该病临床症状、体征缺乏特异性,诊断有一定困难,甚至造成误诊,采用双气囊电子小肠镜结合^99TC^mO4异位胃黏膜核素显像可以提高诊断率,确诊后如有并发症均应手术治疗。现报告本院收治的1例美克尔憩室并发出血病例,同时复习相关文献,总结如下。     

99TcmO-4腹部显像诊断美克尔憩室并出血71例

美克尔憩室并出血是小儿下消化道出血的常见原因。由于其症状、体征缺乏特异性,术前诊断较为困难,而高锝酸盐腹部显像是一种有效的诊断手段[1]。笔者对71例疑为美克尔憩室并出血的患儿进行了99锝m高锝酸盐(99TcmO4-)腹部动态显像,探讨其在美克尔憩室并出血诊断中的价值。1资料与方法1.1对象71例受检者中,男49例,女22例,年龄50天至12岁,全部患儿均以便血为主要表现,血便多为红色或暗红色。体格检查腹部轻压痛或无腹部阳性体征。60例经手术确诊,11例经内镜和其他相关检查确诊。1.2方法检查前禁食水4～6小时,并排空大小便。患儿取仰卧位,99Tc…     

核素腹部显像在儿童美克尔憩室的应用

目的：探讨高99m锝酸盐（99mTcO4-)腹部显像对儿童美克尔憩室的诊断价值。方法：对21例不明原因的消化道出血患儿进行高99m锝酸盐腹部显像。结果：对儿童美克尔憩室的诊断敏感性,特异性和准确性分别为90％,100％和95％。结论：高99m锝酸盐消化道显像是一种无创,简便和安全的美克尔憩室诊断方法,还可作为不明消化道出血的过筛检查。     

小儿消化道出血核素显像42例分析

目的:探讨核素显像在小儿消化道出血原因诊断中的价值。方法:对42例小儿消化道出血进行99TcmO4显像并进行分析。结果:99TcmO4检查发现异常并诊断为Meckel憩室26例,最后经手术和病检确诊23例。结论:Meckel憩室核素腹部显像具有以下特征:(1)与胃影同步出现放射性浓聚区;(2)部位:多发生于右下腹;(3)放射性浓聚灶随时间增强,于注射后30~45 min最浓,其形态、大小和位置相对固定。     

小儿美克尔憩室30例治疗体会

美克尔憩室是常见的消化道畸形，由于临床症状无特异性，术前诊断有一定困难，容易误诊。常因发生消化道出血、憩室炎症、坏死穿孔、肠梗阻等并发症才至医院就诊。现将我院1995年-2005年经手术证实的30例小儿美克尔憩室及其合并症总结如下。     

小儿美克尔憩室外科诊治体会(附24例报告)

目的：小结小儿美克尔憩室外科的诊治体会。方法：回顾性分析24例小儿美克尔憩室外科诊治的临床资料。结论：小儿美克尔憩室并发出血的患儿术前可以通过核素检查确诊。手术切除憩室是唯一治疗方法。     

小儿美克尔憩室的诊断及治疗分析

目的探讨小儿美克尔憩室的术前诊断及手术治疗结果。方法回顾性分析64例手术病理证实为美克尔憩室患儿术前高锝酸盐及超声检查差异,便血与病理的关系,术后并发症情况。结果术前34例行99 m Tc-高锝酸盐放射性核素扫描显像,64例行超声检查,阳性率分别为55. 88%与67. 18%,差异无统计学意义(P 0. 05)。便血组与未便血组患儿术后异位胃黏膜组织病理检查阳性率分别为87. 80%与30. 43%,差异有统计学意义(P 0. 05),腹腔镜与开腹手术术后并发症差异无统计学意义(P 0. 05)。结论 99 m Tc-高锝酸盐放射性核素显像与超声是小儿美克尔憩室诊断的重要检查方法;异位胃粘膜组织与患儿便血密切相关;美克尔憩室患儿手术后恢复普遍较好,并发症少。     

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。     

Radiology of Meckel's diverticulum

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. Approximately 2 to 3% of all individuals have a Meckel's diverticulum and one third of them experience clinical symptoms. Until a decade ago, the correct diagnosis of the lesion was rarely established prior to abdominal surgery or autopsy. However, the introduction of modern imaging techniques and the refinement of gastrointestinal contrast studies have facilitated the preoperative recognition of this entity. This article reviews the radiographic pathology of Meckel's diverticulum and the spectrum of its associated complications.     

Inverted Meckel's diverticulum as a leading point for ileoileal intussusception in an adult: case report

Intussusception due to an inverted Meckel's diverticulum is considered a rare occurrence. We present a case of a 37-year-old male with anemia and melena due to an inverted Meckel's diverticulum at the base of an ileoileal intussusception. To our knowledge, this is the first case in which small bowel enema, computed tomography, and magnetic resonance imaging showed the pathology. Received: 5 April 2001/Accepted: 2 May 2001     

Isolated axial volvulus of a Meckel's diverticulum

A 3.5-year-old boy presented twice within 36 hours to an emergency department with worsening abdominal distress. At surgery, an isolated axial volvulus of a Meckel's diverticulum was found. This finding has been reported three times in the last 20 years and has involved only adult patients. Meckel's diverticulum, although uncommon, can be extremely serious. Its presentation and pathophysiology are reviewed.     

Association of Meckel's diverticulum and Crohn's disease

A significant association between Meckel's diverticulum and Crohn's disease has been suggested in the clinical literature. Ten patients with both entities demonstrated radiographically as well as cases reported in the literature were analyzed to determine the relevance of this association to radiologic evaluation. The Meckel's diverticulum in most cases was an incidental finding whereas the Crohn's disease usually accounted for the patient's clinical symptoms. Recognition of this association should prevent unnecessary laparotomy for an incidental Meckel's diverticulum and improve the radiographic diagnosis of coexistent Crohn's disease.     

Angiographic findings of Meckel's diverticulum: The characteristic appearance of the vitelline artery

Angiographic findings of the vitelline artery in five patients with surgically proven Meckel's diverticulum were reviewed retrospectively. Superselective vitelline arteriography was performed in two patients and superior mesenteric arteriography in three. Arteriography showed the elongated artery without branching originating from the distal ileal artery and a group of tortuous vessels at the distal portion of this artery in all patients. A dense capillary staining of the vitelline artery was exclusively shown in patients with ectopic gastric mucosa. In one patient, injection of methylene blue intraoperatively through a previously placed angiographic catheter into the vitelline artery stained only the vitelline artery and Meckel's diverticulum in blue but neither the mesentery nor the ileum. Demonstration of a nonbranching artery from the ileal artery and a group of dilated tortous vessels at the distal portion of this artery should suggest the possibility of Meckel's diverticulum and can be confirmed by selective injection of the artery. It should be emphasized that angiography can detect Meckel's diverticulum even in the absence of acute bleeding.     

小儿美克尔憩室继发肠套叠的高频超声表现

目的探讨高频超声对小儿美克尔憩室继发肠套叠的诊断价值。方法回顾性分析15例经手术和病理证实为美克尔憩室继发肠套叠患儿的术前超声诊断和声像图特征。结果 15例患儿术前超声检查均发现肠套叠,肠套叠诊断符合率100%。超声发现美克尔憩室11例,病因诊断符合率73.3%。美克尔憩室继发肠套叠的典型高频声像图表现:美克尔憩室位于套叠头端,横断面呈一厚壁囊状结构,纵断面呈一椭圆形或管形结构,一端为盲端,另一端与肠管相连。结论术前超声检查不仅可以明确肠套叠的诊断,而且还能发现大部分美克尔憩室的存在,可作为美克尔憩室继发肠套叠的首选检查方法。     

Meckel's diverticulum and duplication of the alimentary tract

Meckel's diverticulum and duplication of the alimentary tract are very important as the congenital anomalies of ileum. As these two diseases have the common clinical characteristics such as sex, age, symptoms and complications, it is often difficult to diagnose before surgery. This report describes and compared the clinical aspects of Meckel's diverticulum and duplication of the alimentary tract, which were experienced at Nagoya University Hospital and Kariya Toyota General Hospital.     

Meckel's diverticulum

Meckel's diverticulum, a relatively common congenital anomaly of the gastrointestinal tract, is present in approximately 2 percent of the population. When symptoms develop, they are usually the result of inflammation, hemorrhage or obstruction. Diagnosis is made by maintaining a high index of suspicion, carefully reviewing data from the history and physical examination, and performing a radionuclide scan. Surgical removal is usually indicated when symptoms occur. An asymptomatic Meckel's diverticulum that is discovered incidentally at surgery should usually be removed unless contraindications exist.     

Recurrent bleeding from Meckel's diverticulum in an adult: angiographic demonstration after normal scans

We have reported the case of a 26-year-old man who had had intermittent but severe gastrointestinal bleeding over a 30-month period from a Meckel's diverticulum. Meckel's diverticulum should be searched for angiographically, even in the face of normal isotopic scans, in cases of chronic or intermittent gastrointestinal hemorrhage, particularly in younger patients.     

Wireless capsule endoscopic detection of Meckel's diverticulum after nondiagnostic surgery

A patient aged 26 was investigated for recurrent severe gastrointestinal bleeding. Over a 4-year period, he was transfused more than 400 units of blood. Multiple investigations included three negative Meckel's scans. A right hemicolectomy for supposed angiodysplasia failed to control his bleeding. Wireless capsule endoscopy demonstrated the presence of a Meckel's diverticulum. At a repeat laparotomy, the ulcerated Meckel's diverticulum was identified and resected. The patient had no further bleeding and had a normal haemoglobin level on repeat blood tests up to 12 months after surgical excision of the diverticulum.