The value of repeat scintigraphy in patients with a high clinical suspicion for Meckel diverticulum after a negative or equivocal first Meckel scan

Reza Vali, Alan Daneman, Susan McQuattie, Amer Shammas
Pediatric Radiology 2015, 45 (10): 1506-14

BACKGROUND: Technetium (99m)Tc-pertechnetate is the most common and accurate noninvasive method of preoperative investigation for Meckel diverticulum. Despite introducing various methods to increase the sensitivity of the study, there are many case reports of false-negative Meckel scans. A repeat scan is sometimes requested in patients with a high suspicion for Meckel diverticulum and negative or equivocal first Meckel scan.

OBJECTIVES: The purpose of this retrospective study is to evaluate the value of repeat scintigraphy for these patients.

MATERIALS AND METHODS: Seven hundred fifty-three Meckel scans were recorded retrospectively. In 33 cases (22 male and 11 female; mean age: 6.8 years), the Meckel scintigraphy was repeated either due to a high clinical suspicion of Meckel diverticulum and a negative study (n = 21) or due to equivocal findings in the first scan (n = 12). The study was interpreted as positive if an abnormal focal activity was identified in the abdomen and pelvis during the procedure. The results were correlated with pathology and clinical symptoms.

RESULTS: Seven out of 12 (58%) equivocal studies were positive on the second study. Six of them were proven to be positive at operation (confirmed by pathology) while one of them was negative on laparoscopy. From 21 negative first scans with a high suspicion for Meckel diverticulum, three (14%) were positive on the second study. All three were proven to be Meckel diverticulum on pathology.

CONCLUSION: Repeat Meckel scans in patients with equivocal findings on the first study or a negative result with a high clinical suspicion for a Meckel diverticulum are useful especially in cases in which the first study had been done without appropriate preparation.

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