Focal activity in early phase scan should not be ignored: gastrointestinal stromal tumor detected on Tc-99m pertechnetate imaging

Excreted 99m Tc-Pertechnetate in a Renal Pelvis as a Potential False Positive in a Meckel's Scan

ABSTRACT

A 14-year-old girl presented with right lower quadrant pain. A 99m Tc-pertechnetate scan with SPECT/CT was performed to exclude a Meckel's diverticulum. The images demonstrated focal tracer uptake in the right midabdomen, which appeared early and decreased over time. However, SPECT/CT revealed that this uptake corresponded to the right renal pelvis, which was located more inferior than expected. This case emphasizes the importance of recognizing anatomic variants that may cause focal tracer uptake, as well as leveraging an understanding of tracer kinetics to inform a diagnosis.

Similar Appearance on Dynamic Images of Meckel Scintigraphy Caused by Different Etiologies: The Value of Lateral Views

Positive gastric mucosa Meckel diverticulum generally shows nonmoving activity in the right abdomen, which appears early in the study at about the same time of the appearance of the stomach. However, a stoma from ileostomy can result in similar findings on dynamic images. The difference between a true Meckel diverticulum and stoma can be exposed by lateral views.

Elongated Appearance of Meckel's Diverticulum on 99mTcO4 Scintigraphy

A Meckel's scintigraphy using TcO4 was performed in a 9-year-old boy. The images revealed an elongated abnormal radiotracer accumulation in the right abdomen, which was confirmed as Meckel diverticulum combined with an omphalomesenteric cyst.

Aspiration Incidentally Detected by a Meckel Scintigraphy

Meckel scintigraphy with Tc-pertechnetate was performed in a 5-year-old boy to determine whether a Meckel diverticulum containing ectopic gastric mucosa caused bleeding. The images did not reveal focal activity characteristic of a Meckel diverticulum. Unexpectedly, activity in the tracheobronchial tree was visualized, consistent with aspiration of the radioactive saliva.

Rectal juvenile polyp detected on (99m)Tc-pertechnetate abdominal scintigraphy (Meckel scan)

An 8-year-old boy presented with first episode of rectal bleeding. Initial hemoglobin was 9 g/dL. A Meckel scan showed a hyperemic focus in the lower pelvis. Colonoscopy identified a juvenile polyp with dysplasia in the rectosigmoid region. It is important to carefully evaluate the dynamic flow images in the Meckel scan because pathology other than a Meckel diverticulum may be identified.