Meckel's Scan

  • Localization of a Meckel's diverticulum with functioning gastric mucosa
  • Detection of gastrointestinal bleeding
  • Blood in feces
  • Increased abdominal pain (children especially)
    Intestinal obstruction
  • Diverticulitis
  • Intestinal obstruction

  • procedures such as colonoscopy/laxitives can result in nonspecific Tc-99m pertechnetate uptake and should be avoided
  • Barium studies should not be performed several days before because attenuation by contrast material may prevent lesion detection
  • certain drugs, such as suximide may also cause unpredictable uptake

Radiopharmaceutical information:
  • Radionuclide:Tc-99 m
  • Radiopharmaceutical: Tc-99 m pertechnetate
  • Adult dosing: 5-10 mCi
  • Pediatric dosing: 30-100 µCi/kg(minimal dose 200 uCi)
  • Method of administration: Intravenously
  • Method of Localization: Active Transport (concentrated rapidly secreted by mucin-secreting cells)
  • Physical Half-life: 6 hours

Patient Preparation:
  • NPO 4-6 hours prior to reduce size of stomach
  • No pretreatment with sodium perchlorate (can be given after study is done)
  • No barium studies with 3-4 days of scan
  • Void before, during if possible and after study
  • Cimetidiine (20mg/kg) orally 24 hours and 1 hour prior to the study. (This is an H2 blocker which inhibits the release of the radiotracer from the gastric mucosa)
Equipment Used:
Camera: large field of view gamma
Collimator used: LEHR or LEAP

Acquisition Setup:

a. Optional acquisition of anterior abdominal
flow images (1–5 sec/frame x 1 min).
b. Anterior abdominal images at a frame rate
of one image every 30–60 sec for at least 30
min (some favor 60 min).
c. Additional static images, anterior oblique
projections, laterals and posterior projection views
are recommended at the end of the dynamic acquisition.
Stopping the dynamic acquisition to obtain these images
when abnormal activity is first seen can be
helpful to distinguish activity in a Meckel’s
diverticulum from activity in the kidney,
ureter or bladder. Post-void images can
also be helpful to detect activity in a
Meckel’s diverticulum observed by the urinary

Dynamic: View(s)
Matrix: 128x128
Time/Frame: 1 sec/frame
Number of Frames: 60 frames

Statics: View(s)
Matrix: 128x128
Total Counts or Duration:
  • First Image: 500k counts
  • All other Images: every 5-10 minutes for 1 hour
  • Upright, right lateral, posterior, or oblique views can be done: At 30 and 60 minutes
  • Also take a post void image

Describe the procedure from verifying the requisition to completing the scan. Include any patient instructions pre- or post- injection/scan, delays between injection and imaging, and any side effects.
  1. Tc-99m-pertechnetate (8-12 mCi) is injected intravenously.
  2. A series of dynamic and static images are obtained. The examination last about 30 - 60 minutes.
  3. Patient will be lying supinely.
Normal Uptake and varients:
It is normal to see increased gastric uptake and some renal activity in the first 20 to 30 mintues of the study but then decreasing s the study continues on.The bladder uptake will increase with the time of the study. Reasons for this is becasue the radiopharmaceutical is wrking its way out of the body through the kidneys and into the baldder.

Abnormal Uptake and causes:
Insert an image of an abnormal scan. Describe the abnormal uptake, and the cause of the abnormal uptake.

In the right lower quadrant, medially distal to the right ureter there is a focal uptake.


Questions asked in Patient History:

When was the last time you had anything to eat or drink?

Have you had any other studies done? If so, What and when?

What medications are you on?

Any history of cancer?

Any pain? If so, where, for how long?

Any lab results taken already?

Are you pregnant or breastfeeding?