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IMAGE INTERPRETATION · HEPATOBILIARY AND GI

Meckel’s Diverticulum Scan with Tc-99m Pertechnetate

Dynamic abdominal scan: sequential frames at 3 min/frame from 30 to 60 minutes post-injection
Dynamic abdominal scan: sequential frames at 3 min/frame from 30 to 60 minutes post-injection

Provided clinical image

Question

In this dynamic abdominal study acquired at 3 minutes per frame, a focal area of increased activity appears in the lower abdomen at the same time as a large upper abdominal organ. Which radiopharmaceutical is used, and why does it accumulate in this abnormal location?

  1. ATc-99m DTPA; the tracer is filtered by the kidneys and accumulates in areas of urinary tract obstruction, causing the focal lower abdominal uptake seen in this dynamic series
  2. BTc-99m sulfur colloid; the tracer is taken up by reticuloendothelial cells and accumulates in ectopic liver tissue that can develop in the lower abdomen during fetal development
  3. CTc-99m pertechnetate; the tracer is taken up by gastric mucosa, and ectopic gastric mucosa within a Meckel's diverticulum causes the focal lower abdominal uptake seen in this study
  4. DTc-99m MDP; the tracer binds to areas of osteoblastic activity and accumulates in calcified soft tissue deposits that can form within abdominal diverticula
Show the answer and explanation

C. Tc-99m pertechnetate; the tracer is taken up by gastric mucosa, and ectopic gastric mucosa within a Meckel's diverticulum causes the focal lower abdominal uptake seen in this study

Tc-99m pertechnetate is used for this study. It is taken up and secreted by mucous cells of gastric mucosa. In a Meckel's diverticulum, approximately 50% of cases contain ectopic gastric mucosa, which accumulates pertechnetate just like normal stomach tissue. On a positive scan, focal uptake appears in the lower abdomen (typically right lower quadrant) simultaneously with stomach uptake and persists throughout the dynamic series. The study is acquired at 3 min/frame for 45–60 minutes.

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← Patient Preparation for a HIDA ScanAcute Cholecystitis on HIDA Scan with Morphine →

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