Practical advantage of SPECT/CT image co-registration for accurate bleeding Meckel’s diverticulum localization in pediatrics: A case report
Planar scintigraphy with 99m Tc-pertechnetate or Meckel scan is the gold standard in the diagnosis of a bleeding Meckel’s diverticulum (MD) for pediatrics. However, several setbacks may occur during the interpretation of a scintigram, especially in cases of an atypical MD presentation. In this repor...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-01-01
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| Series: | Proceedings of Singapore Healthcare |
| Online Access: | https://doi.org/10.1177/20101058211031036 |
| _version_ | 1818468453224284160 |
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| author | Nashrulhaq Tagiling Vincent Wei Shen Tee Yeong Yeh Lee Nur Asyilla Che Jalil Norazlina Mat Nawi |
| author_facet | Nashrulhaq Tagiling Vincent Wei Shen Tee Yeong Yeh Lee Nur Asyilla Che Jalil Norazlina Mat Nawi |
| author_sort | Nashrulhaq Tagiling |
| collection | DOAJ |
| description | Planar scintigraphy with 99m Tc-pertechnetate or Meckel scan is the gold standard in the diagnosis of a bleeding Meckel’s diverticulum (MD) for pediatrics. However, several setbacks may occur during the interpretation of a scintigram, especially in cases of an atypical MD presentation. In this report, we highlight the importance of functional and anatomical image co-registration using a hybrid SPECT/CT scanner to precisely localize a MD lesion. An 18-month-old boy presented with severe hematochezia over 4 days with declining hemoglobin levels. He underwent a conventional 60-min dynamic planar imaging of the Meckel scan. Upon review of the Meckel scan, a suspicious increase in the 99m Tc-pertechnetate uptake was observed at the right upper quadrant of the abdomen. Due to its atypical location at the right kidney, we could not differentiate between a physiological uptake of the right kidney or an ectopic gastric mucosa. The patient was imaged again using single-photon emission computed tomography (SPECT) and low-dose CT protocol with a hybrid SPECT/CT scanner, and the co-registration of both SPECT and CT images was able to confirm the MD, which was located anterior to the right kidney at the right hepatic flexure region. An exploratory laparotomy was then ensued to remove the bleeding MD. The patient was discharged after 3 days with no complications. In summary, this case illustrates that hybrid imaging modality and co-registration allow for a more definitive diagnosis, as well as a more precise localization of MD. |
| first_indexed | 2024-04-13T21:12:20Z |
| format | Article |
| id | doaj.art-85e8a76c7a24476ba8e2932f2730f014 |
| institution | Directory Open Access Journal |
| issn | 2059-2329 |
| language | English |
| last_indexed | 2024-04-13T21:12:20Z |
| publishDate | 2022-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Proceedings of Singapore Healthcare |
| spelling | doaj.art-85e8a76c7a24476ba8e2932f2730f0142022-12-22T02:29:48ZengSAGE PublishingProceedings of Singapore Healthcare2059-23292022-01-013110.1177/20101058211031036Practical advantage of SPECT/CT image co-registration for accurate bleeding Meckel’s diverticulum localization in pediatrics: A case reportNashrulhaq TagilingVincent Wei Shen TeeYeong Yeh LeeNur Asyilla Che JalilNorazlina Mat NawiPlanar scintigraphy with 99m Tc-pertechnetate or Meckel scan is the gold standard in the diagnosis of a bleeding Meckel’s diverticulum (MD) for pediatrics. However, several setbacks may occur during the interpretation of a scintigram, especially in cases of an atypical MD presentation. In this report, we highlight the importance of functional and anatomical image co-registration using a hybrid SPECT/CT scanner to precisely localize a MD lesion. An 18-month-old boy presented with severe hematochezia over 4 days with declining hemoglobin levels. He underwent a conventional 60-min dynamic planar imaging of the Meckel scan. Upon review of the Meckel scan, a suspicious increase in the 99m Tc-pertechnetate uptake was observed at the right upper quadrant of the abdomen. Due to its atypical location at the right kidney, we could not differentiate between a physiological uptake of the right kidney or an ectopic gastric mucosa. The patient was imaged again using single-photon emission computed tomography (SPECT) and low-dose CT protocol with a hybrid SPECT/CT scanner, and the co-registration of both SPECT and CT images was able to confirm the MD, which was located anterior to the right kidney at the right hepatic flexure region. An exploratory laparotomy was then ensued to remove the bleeding MD. The patient was discharged after 3 days with no complications. In summary, this case illustrates that hybrid imaging modality and co-registration allow for a more definitive diagnosis, as well as a more precise localization of MD.https://doi.org/10.1177/20101058211031036 |
| spellingShingle | Nashrulhaq Tagiling Vincent Wei Shen Tee Yeong Yeh Lee Nur Asyilla Che Jalil Norazlina Mat Nawi Practical advantage of SPECT/CT image co-registration for accurate bleeding Meckel’s diverticulum localization in pediatrics: A case report Proceedings of Singapore Healthcare |
| title | Practical advantage of SPECT/CT image co-registration for accurate bleeding Meckel’s diverticulum localization in pediatrics: A case report |
| title_full | Practical advantage of SPECT/CT image co-registration for accurate bleeding Meckel’s diverticulum localization in pediatrics: A case report |
| title_fullStr | Practical advantage of SPECT/CT image co-registration for accurate bleeding Meckel’s diverticulum localization in pediatrics: A case report |
| title_full_unstemmed | Practical advantage of SPECT/CT image co-registration for accurate bleeding Meckel’s diverticulum localization in pediatrics: A case report |
| title_short | Practical advantage of SPECT/CT image co-registration for accurate bleeding Meckel’s diverticulum localization in pediatrics: A case report |
| title_sort | practical advantage of spect ct image co registration for accurate bleeding meckel s diverticulum localization in pediatrics a case report |
| url | https://doi.org/10.1177/20101058211031036 |
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