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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

View larger version (95K): [in a new window]   Figure 1. Case 1: Meckel's diverticulum. (a,b) 99Tcm-pertechnetate scintigraphy images showing focal area of intense abnormal tracer accumulation in the hypogastrium appearing at the same time as gastric mucosal uptake, this pattern is characteristic of Meckel's diverticulum.

View larger version (123K): [in a new window]   Figure 2. Case 3: Meckel's diverticulum. (a–c) Serial 99Tcm-pertechnetate scintigraphic images showing a small focus of abnormal tracer accumulation in the right lower quadrant near the midline that appears with appearance of stomach and increases roughly in synchrony with gastric accumulation. (d) The remnant of the omphalomesenteric duct still connected to the umbilicus is seen in the photo taken at surgery.

View larger version (72K): [in a new window]   Figure 3. Case 4: Intestinal duplication. 99Tcm-pertechnetate scintigraphy (dynamic images) showing abnormal tracer accumulation in the lower abdominal region appearing at the same time as gastric mucosal uptake and progressively increasing in intensity.

View larger version (133K): [in a new window]   Figure 4. Case 5: Intestinal duplication. 99Tcm-pertechnetate scintigraphic (a) early and (b) 60 min delayed images showing a linear area of abnormal uptake in the infraumbilical region along the midline appearing at the same time as gastric mucosal uptake and progressively increasing in intensity.

View larger version (64K): [in a new window]   Figure 5. Cases 6 and 7: Intestinal duplication. (a) 99Tcm-pertechnetate scintigraphic images show an initial blush of tracer activity on the dynamic flow images. (b) The early images then show intense tracer accumulation in the lower abdomen simultaneous to gastric visualization. (c) The tracer localization changes configuration on the delayed images. (d) The long tubular ileal duplication is seen in the photo taken at surgery.

View larger version (90K): [in a new window]   Figure 6. Case 8: Gastric duplication cyst. 99Tcm-pertechnetate scintigraphic 60 min delayed image showing abnormal tracer accumulation infero-medial to the stomach appearing at the same time as gastric mucosal uptake.

View larger version (91K): [in a new window]   Figure 7. Cases 9 and 10: Thorasic duplication cyst. 99Tcm-pertechnetate scintigraphy in (a) the early phase shows an intrathorasic photodeficient area in the chest, which fills with tracer in (b) the 6 h delayed image.

View larger version (152K): [in a new window]   Figure 8. Case 11: Thoracic duplication cyst. 99Tcm-pertechnetate scintigraphic serial images at (a) 15 min, (b) 4 h and (c) 24 h showing an intrathoracic photopenic area in the right hemithorax on the early image, which is seen to fill up with tracer on the 24 h delayed image. (d) Chest radiograph posteroanterior view shows a well-defined posterior mediastinal mass in the right paratracheal region. (e) Contrast enhanced axial CT chest seen on the mediastinal window shows a well circumscribed fluid attenuating, non-enhancing mass in right paratracheal location.