梅克爾氏憩室閃爍診斷分析及文獻回顧

Scintigraphic Analysis of Meckel's Diverticulum and Literature Review

蔡道桂(Daw-Guey Tsay) ； 陳維廉(Wei-Lian Chen) ； 劉仁賢(Ren-Shyan Liu)

《中華放射線醫學雜誌》 9卷2期 (1984/06) Pp. 125-133

摘要

梅克爾氏憩室是一種解剖和胚胎生長上的變異，很難在外科手術以前用其他方法診斷出來。藉著胃粘膜既使是異位性者，均能在腹部閃爍造影檢查中蝟集放射性同位素鎝－99m製劑的特性，得以逕行測知梅克爾氏憩室的存在。在我們16例疑似本病的病患，用核子醫學造影檢查後：9例是陽性反應，其中7例經外科及病理證實為真陽性，1例爲假陽性，1例未經外科證實，而7例陰性反應者並無偽陰性出現。就本研究的閃爍造影分析及有關文獻回顧，核子醫學造影檢查，比起其他的診斷方法，均有較高的靈敏度，專一性及安全性，確有臨床推廣應用的價值。核子醫學的優點在強調病變部位的生理和功能變化的偵測，雖然各種臨床診斷方法都是相輔相成的，而閃爍造影無疑地是偵測梅克爾氏憩室有效的第一線工具。

並列摘要

Meckel's diverticulum is recognized as an anatomically and etiologically characteristic disease. Various approaches to it are of very difficulty to make a preoperative diagnosis. By means of the fact that gastric mucosa, even ectopic, may gather free Tc-99m pertechnetate, the recent use of the radio-pharmaceutical agent for abdominal scans made it possible to detect some Meckel's diverticula accurately. In our 16 suspicious cases of Meckel's diverticulum, 9 give positive findings--localized accumulation of radioactivity (7 true positive, proved by surgery and pathology, 1 false positive and 1 unproved) and 7 true negative (no false negative discerned) Comparing with the other diagnostic methods, promotion of the radionuclide approach is worth while by advantage of its high sensitivity, specificity and safety, which can be evidenced in literature. The merit of the nuclear medicine emphasizes easy detection of the physiological and functional changes in the very anomaly. In spite of the fact that all diagnostic ways are complementary, the radionuclide scintigraphy is proved undoubtfully an effective first line approach to Meckel's diverticulum.