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Tc-99m scan for pediatric bleeding Meckel diverticulum:a systematic review and meta-analysis
1Sichuan University, West China Hospital, Department of Gastroenterology, Sichuan, China.
Objective:
Meckel diverticulum (MD) is a common malformation of the digestive tract, often accompanied by serious complications. It is important to find safe and effective diagnostic methods for screening MD. The aim of this study was to evaluate the effectiveness of a technetium-99m (Tc-99m) scan for pediatric bleeding MD.
Methods:
The authors conducted a systematic review of studies published in PubMed, Embase, and Web of Science before 1 January 2023. Studies based on PICOS were included in this systematic review. The flow chart was made by PRISMA software. The quality of included studies was assessed by RevMan5 software (QUADAS-2: Quality Assessment of Diagnostic Accuracy Studies-2). The sensitivity, specificity, and other measurements of accuracy were pooled using Stata/SE 12.0 software.
Results:
Sixteen studies with 1115 children were included in this systematic review. A randomized-effects model was used for the meta-analysis because of significant heterogeneity. The combined sensitivity and specificity were 0.80 [Confidence Interval (95% CI, 0.73-0.86) and 0.95 (95% CI, 0.86-0.98)], respectively. The area under the curve (AUC) was 0.88 (95% CI, 0.85-0.90). Publication bias (Begg's test p = 0.053) was observed.
Conclusion:
Tc-99m scan has high specificity, but moderate sensitivity, which is always influenced by some factors. Hence, the Tc-99m scan has some limitations in the diagnosis of pediatric bleeding MD.
Insights
The technetium-99m (Tc-99m) scan shows high specificity but moderate sensitivity for diagnosing pediatric bleeding Meckel diverticulum (MD). This diagnostic tool has limitations, impacting its effectiveness in identifying this common digestive tract malformation.
Area of Science:
- Gastroenterology
- Nuclear Medicine
- Pediatric Surgery
Background:
- Meckel diverticulum (MD) is a frequent congenital anomaly of the digestive tract.
- MD can lead to severe complications, necessitating effective diagnostic strategies.
- Accurate and safe diagnostic methods are crucial for screening pediatric patients with bleeding MD.
Conclusions:
- The Tc-99m scan demonstrates high specificity but only moderate sensitivity for diagnosing pediatric bleeding MD.
- Diagnostic accuracy is influenced by various factors, indicating inherent limitations.
- While useful, the Tc-99m scan requires careful consideration of its limitations in clinical practice.
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