COMPARISON OF MECKEL’S SCINTIGRAPHY IN CHILDREN: PREMEDICATION WITH PENTAGASTRIN VERSUS PENTAGASTRIN PLUS H,-RECEPTOR BLOCKER (RANITIDINE)
Keywords:
Meckel’s, ectopic gastric mucosa, pentagastrin, H2 receptor blocker, Tc-99m pertechnetateAbstract
BACKGROUND: Premedicating with various drugs prior to Tc-99m pertechnetate scintigraphy has been proposed for augmenting the detection of Meckel’s diverticulum. This study aims to document the actual sensitivity, specificity, accuracy, positive, and negative predictive values of premedication with pentagastrin and pentagastrin plus ranitidine, which has not been documented before, and to compare the efficacy of these two protocols.
METHODS: Two premedication protocols were followed. 181 Meckel’s scans with pentagastrin stimulation were performed in 180 patients. and 49 scans with both pentagastrin and ranitidine stimulation in 49 patients. These were retrospectively reviewed and analysed for the efficacy of each protocol. and the two groups were compared.
RESULTS: The sensitivity, specificity, accuracy, positive, and negative predictive values of the group premedicated with pentagastrin were 71.4%, 99.4%, 96.1%. 93.8%, 96.4%, respectively, and the group with pentagastrin plus ranitidine were 80%, 100%, 98%, 100%, 97.8%, respectively. Considering those patients in whom there was an identifiable cause for the symptoms, including Meckel’s diverticulum the sensitivity, specificity, accuracy, positive, and negative predictive values were 71.4%, 99.1%, 94.8%, 93.8%, 95.0%, respectively, for the pentagastrin group, and 80%, 100%, 97.4%, 100%, 97.1%, respectively for the pentagastrin plus ranitidine group. There was no significant statistical difference in the sensitivity and specificity between these two groups (p>0.05). Conclusion: Meckel’s scans using pentagastrin plus ranitidine slightly, but not significantly improves sensitivity and specificity for the detection of Meckel’s diverticulum compare with pentagastrin alone. Positive and negative predictive values of both premedication protocols are very high, ranging from 93.8%-100%.
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