Skip to main content

Detection of ectopic gastric mucosa using 99mTc pertechnetate: review of the literature

Annals of Nuclear Medicine volume 23, pages 97–105 (2009)Cite this article

Abstract

Technetium-99m (99mTc) pertechnetate scintigraphy in a child with acute gastrointestinal bleeding of unknown origin suggests ectopic gastric mucosa caused by Meckel’s diverticulum or gastrointestinal duplication cysts. Our objective was to define the patterns of scintigraphic findings likely to be encountered in patients with ectopic gastric mucosa with illustrative cases and to review the literature. Fifty children (age 1 year to 14 years) were evaluated for ectopic gastric mucosa using 99mTc pertechnetate scintigraphy. Functioning ectopic gastric mucosa was detected in eight patients with Meckel’s diverticula and three patients with bowel duplication. Three patients showed atypical findings on scintigraphy which were perforated appendix, calyceal stasis, and regional enteritis. Ectopic functioning gastric mucosa in Meckel’s diverticulum is visualized simultaneously with the stomach, whereas in intestinal duplications tracer activity can be visualized in the dynamic sequence or before gastric tracer visualization in an irregular pattern. A variety of scintigraphic patterns can be found in patients with ectopic gastric mucosa undergoing 99mTc pertechnetate scintigraphy depending on the location and size of the ectopic tissue. Also, acquisition of delayed images is useful when the initial images are equivocal in children.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Amoury RA, Snyder CL. Meckel diverticulum. In: O’Neill JA, Rowe MI, Grosfeld JL, et al., editors. Pediatric surgery. St. Louis: Mosby-Year Book; 1998, p. 1173–1184.

    Google Scholar 

  2. Sfakianakis GN, Haase GM. Abdominal scintigraphy for ectopic gastric mucosa: a retrospective analysis of 143 studies. Am J Roentgenol 1982;138:7–12.

    CAS  Google Scholar 

  3. Sfakianakis GN, Conway JJ. Detection of ectopic gastric mucosa in Meckel’s diverticulum and in other abnormalities by scintigraphy. II. Indications and methods: a 10-year experience. J Nucl Med 1981;22:732–738.

    PubMed  CAS  Google Scholar 

  4. Kong MS. Technetium pertechnetate scan for ectopic gastric mucosa in children with gastrointestinal bleeding. J Formos Assoc 1993;92:717–720.

    CAS  Google Scholar 

  5. Fries M, Mortensson W, Robertson B. Technetium pertechnetate scintigraphy to detect ectopic gastric mucosa in Meckel’s diverticulum. Acta Radiol Diagn 1984;25:417–422.

    CAS  Google Scholar 

  6. Dixon PM, Nolan DJ. The diagnosis of Meckel’s diverticulum: a continuing challenge. Clin Radiol 1987;38:615–619.

    PubMed  Article  CAS  Google Scholar 

  7. Schwartz MJ, Lewis JH. Meckel’s diverticulum pitfalls in scintigraphic detection in the adult. Am J Gasteroenterol 1984;79:611–618.

    CAS  Google Scholar 

  8. Luckier LS, Dohan O, Li Y, Chang CJ, Carrasco N, Dadachova E. Kinetics of perrhenate uptake and comparative biodistribution of perrhenate, pertechnetate and iodide by NaI symporter-expressing tissues in vivo. J Nucl Med 2004;45:500–507.

    Google Scholar 

  9. Hill P, Rode J. Helicobacter pylori in ectopic gastric mucosa in Meckel’s diverticulum. Pathology 1998;30:7–9.

    PubMed  Article  CAS  Google Scholar 

  10. Morris A, Nicholson G, Zwi J, Vanderwee M. Campylobacter pylori infection in Meckel’s diverticula containing gastric mucosa. Gut 1989;30:1233–1235.

    PubMed  Article  CAS  Google Scholar 

  11. Maggi G, Navarra L, Cianca G, Vittorini V, Ciccarelli O, Pietroletti R, et al. Ectopic pancreas in Meckel’s diverticulitis: a description of a new clinical case. Ann Ital Chir 2002;73:647–649.

    PubMed  CAS  Google Scholar 

  12. Artigas V, Calabuig R, Badia F, Rius X, Allende L, Jover J. Meckels diverticulum: value of ectopic tissue. Am J Surg 1986;151:631–634.

    PubMed  Article  CAS  Google Scholar 

  13. Gross RE, Holcomb GW Jr, Farber S. Duplications of the alimentary tract. Pediatrics 1952;9:449–452.

    Google Scholar 

  14. Holcomb GW III, Gheissari A, O’Neill JA Jr, Shorter NA, Bishop HC. Surgical management of alimentary tract duplications. Ann Surg 1989;209:167–174.

    PubMed  Article  Google Scholar 

  15. Bond SJ, Groff DB. Gastrointestinal duplications. In: O’Neill JA Jr, Rowe MI, Grosfeld JL, Fonkalrud EW, Coran AG, editors. Pediatric surgery, vol. 2, 5th ed. St Louis: Mosby; 1998. p. 1257–1267.

    Google Scholar 

  16. Kumar R, Tripathi M, Chandrashekar N, Agarwala S, Kumar A, Dasan JB, et al. Diagnosis of ectopic gastric mucosa using 99mTc pertechnetate: spectrum of scintgraphic findings. Br J Radiol 2005;78:714–720.

    PubMed  Article  CAS  Google Scholar 

  17. Jewett TC, Duscynski DO, Allen JE. The visualisation of Meckel’s diverticulum with Tc-99m pertechnetate. Surgery 1970;68:567–570.

    PubMed  Google Scholar 

  18. Treves S, Grand RJ, Eraklsi AJ. Pentagastrin stimulation of 99mTc uptake by ectopic gastric mucosa in a Meckel’s diverticulum. Radiology 1978;128:711–712.

    PubMed  CAS  Google Scholar 

  19. Diamond RH, Rothstein RD, Alavi A. The role of simetidine enhanced 99mTc pertechnetate imaging for visualising Meckels diverticulum. J Nucl Med 1991;16:1422–1424.

    Google Scholar 

  20. Sfakianakis GN, Anderson GF, King DR, Boles ET. The effect of gastrointestinal hormones on the pertechnetate imaging of ectopic gastric mucosa in experimental Meckel’s diverticulum. J Nucl Med 1981;22:678–683.

    PubMed  CAS  Google Scholar 

  21. Chaudhuri TK, Chaudhuri TK, Christie JH. False positive Meckel’s scan. Surgery 1972;71:313.

    PubMed  CAS  Google Scholar 

  22. Fink-Bennett D. The uterine blush: a potential false-positive in Meckel’s scan interpretation. Clin Nucl Med 1982;7:444.

    PubMed  Article  CAS  Google Scholar 

  23. Berquist TH, Nolan NG, Stephens DH, Carlson HC. Specificity of 99mTc pertechnetate in scintigraphic diagnosis of Meckel’s diverticulum: review of 100 cases. J Nucl Med 1976;17:465–469.

    PubMed  CAS  Google Scholar 

  24. Connoly L, Treves T, Bozorgi F, O’Connor SC. Meckel’s diverticulum: demonstration of heterotropic gastric mucosa with Tc-99m pertechnetate SPECT. J Nucl Med 1998;39:1458–1460.

    Google Scholar 

  25. Ford PV, Bartold SP, Fink-Bennett D, Lull RJ, Maurer AH, Seabold JE. Society of Nuclear Medicine Procedure Guidelines for Gastrointestinal Bleeding and Meckel’s Diverticulum Scintigraphy Society of Nuclear Medicine Procedure Guidelines Manual. June 2002.

Download references

Author information

Affiliations

  1. Department of Nuclear Medicine, Hacettepe University, Medical Faculty, 06100, Sihhiye, Ankara, Turkey

    Pinar O. Kiratli, Tamer Aksoy & Murat F. Bozkurt

  2. Department of Pediatric Pathology, Hacettepe University Medical Faculty, Sihhiye, Ankara, Turkey

    Diclehan Orhan

Authors
  1. Pinar O. Kiratli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tamer Aksoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Murat F. Bozkurt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Diclehan Orhan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pinar O. Kiratli.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kiratli, P.O., Aksoy, T., Bozkurt, M.F. et al. Detection of ectopic gastric mucosa using 99mTc pertechnetate: review of the literature. Ann Nucl Med 23, 97–105 (2009). https://doi.org/10.1007/s12149-008-0204-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-008-0204-6

Keywords

  • Ectopic gastric mucosa
  • Radionuclide imaging
  • Meckel’s diverticulum
  • Pediatrics
  • Intestinal duplication