Incremental value of SPECT/CT in detection of Meckel's diverticulum in a 10-year-old child
Related Experiment Video
Updated: Mar 16, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Qian Xie1, Qingjie Ma1, Bin Ji1
1Department of Nuclear Medicine, China-Japan Union Hospital, Jilin University, 126 Xiantai Avenue, Changchun, 130033 China.
Insights
Meckel's diverticulum can be challenging to diagnose with planar scintigraphy alone. Single photon emission computed tomography/computed tomography (SPECT/CT) fusion imaging offers improved accuracy for definitive diagnosis, especially in ambiguous cases.
Area of Science:
- Pediatric Gastroenterology
- Nuclear Medicine Imaging
Background:
- Meckel's diverticulum is a frequent congenital gastrointestinal anomaly in children.
- Technetium-99m pertechnetate planar scintigraphy is the standard diagnostic tool.
- SPECT/CT fusion imaging can aid in lesion localization.
Purpose of the Study:
- To highlight a challenging case of Meckel's diverticulum diagnosis.
- To evaluate the utility of SPECT/CT in ambiguous scintigraphy findings.
Main Methods:
- A case of Meckel's diverticulum initially diagnosed with planar scintigraphy.
- Recurrence of hematochezia prompted repeat planar scintigraphy.
- SPECT/CT was utilized to clarify ambiguous findings on planar imaging.
Main Results:
- Planar scintigraphy alone was insufficient for diagnosis when findings were near the kidney.
- SPECT/CT provided both functional and anatomical information for definitive diagnosis.
- Fusion imaging precisely localized the Meckel's diverticulum.
Conclusions:
- SPECT/CT imaging is crucial for definitive diagnosis in ambiguous Meckel's diverticulum cases.
- Balancing diagnostic information with radiation exposure is key for SPECT/CT utilization.
Introduction:
Meckel's diverticulum is a common congenital abnormality of gastrointestinal tract in children. Planar scintigraphy using Technetium-99m pertechnetate is widely used in the diagnosis of Meckel's diverticulum. Single photon emission computed tomography/computed tomography (SPECT/CT) fusion imaging may help to locate the Meckel's diverticulum lesion. We now present a Meckel's diverticulum case which tends to be missed.
Case Description:
The patient was diagnosed with Mecke's diverticulum by planar scintigraphy in 2007. After seven years, a recurrence of hematochezia made the patient undergo planar scintigraphy again. However, the concentration on planar image was located at the right kidney level, we could not determine whether it was caused by physiological uptake of the right kidney or by an ectopic gastric mucosa. Using SPECT/CT technique, we confirmed that the lower part of the concentration was from a Meckel's diverticulum from the small intestine based on the functional and anatomical information together.
Discussion And Evaluation:
For concentrations about the kidney level, planar scintigraphy is not enough to be diagnostic of Meckel's diverticulum. SPECT/CT imaging may be beneficial for a definitive diagnosis. Also, fusion images may provide precise localization of the lesion. To make sure that patients obtain optimal benefit from a SPECT/CT examination, we have to balance the priority between information of anatomic location and avoiding redundant radiation to the patients.
Conclusions:
Our case study suggest that for cases with ambiguous planar scintigraphy images, SPECT/CT imaging should be performed to obtain a definitive diagnosis.
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