Meckel diverticulum scintigraphy: technique, findings and diagnostic pitfalls

Pediatr Radiol. 2023 Mar;53(3):493-508. doi: 10.1007/s00247-022-05527-z. Epub 2022 Nov 3.

Abstract

Meckel diverticulum, the most common congenital anomaly of the gastrointestinal tract, results from the aberrant involution of the omphalomesenteric duct and accounts for more than 50% of unexplained lower gastrointestinal bleeding in the pediatric population. The most accurate imaging tool to identify a Meckel diverticulum containing ectopic gastric mucosa is the Technetium-99m pertechnetate Meckel scan, a scintigraphic study with a reported accuracy of 90% in the pediatric population. In addition to depicting a Meckel diverticulum with ectopic gastric mucosa, careful attention to the normal biodistribution of the radiotracer can lead to the identification of unexpected pathology with implications for patient management. This article serves to review the embryological origin and anatomical features of Meckel diverticulum, highlight the role of scintigraphy in evaluating Meckel diverticulum, and discuss the proper imaging technique when performing this test. We will focus on pitfalls that can lead to an erroneous diagnosis as well as incidental findings that can affect patient management.

Keywords: Children; Gastrointestinal bleeding; Meckel diverticulum; Pitfalls; Scintigraphy; Technetium-99m pertechnetate.

Publication types

  • Review

MeSH terms

  • Child
  • Gastrointestinal Hemorrhage / diagnostic imaging
  • Humans
  • Meckel Diverticulum* / diagnostic imaging
  • Musculoskeletal Diseases*
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Sodium Pertechnetate Tc 99m
  • Tissue Distribution

Substances

  • Radiopharmaceuticals
  • Sodium Pertechnetate Tc 99m