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Diagnosis of ectopic gastric mucosa using ⁹⁹Tc^m-pertechnetate: spectrum of scintigraphic findings

Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India

Correspondence: Dr Rakesh Kumar, F-74, Ansari Nagar (West), AIIMS Campus, New Delhi- 110029, India

We highlight the spectrum of scintigraphic findings likely to be encountered in patients with ectopic gastric mucosa with illustrative cases for each such finding. 11 children (aged 4 months to 120 months, all males) underwent ⁹⁹Tc^m-pertechnetate scintigraphic evaluation for ectopic gastric mucosa. Functioning ectopic gastric mucosa was detected in Meckel's diverticulae in three patients, in small bowel duplications in four, in a gastric duplication in one, and in intrathoracic foregut duplication cysts in three. Ectopic functioning gastric mucosa in Meckel's diverticulum, and gastric duplication is visualized simultaneously with the stomach while in intestinal duplications tracer activity can be visualized in the dynamic sequence and even before gastric tracer visualization. In the three patients with intrathoracic duplication cysts, the functioning ectopic gastric mucosa was evident only in the delayed ⁹⁹Tc^m-pertechnetate images, much later than the visualization of stomach activity. Therefore, acquisition of delayed images are useful when the initial images are equivocal or negative in children with intrathoracic foregut duplication cysts. In addition, we suggest a hypothesis of a possible mechanism for the uptake of pertechnetate in ectopic gastric mucosa in some patients with intrathoracic forget duplication cysts. In conclusion, a variety of scintigraphic patterns may be found in patients with ectopic gastric mucosa undergoing ⁹⁹Tc^m-pertechnetate scintigraphy depending upon the location and size of the ectopic tissue.

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