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Nuklearmedizin 1990; 29(05): 204-209
DOI: 10.1055/s-0038-1629532
Deutsche Gesellschaft für Nuklearmedizin

Dynamic Scintigraphy of the Oesophagus in the Evaluation of Reflux Oesophagitis

Dynamische Szintigraphie des Ösophagus bei der Beurteilung der Refluxösophagitis
Ž. Babić
1   From the Department of Nuclear Medicine, University Hospital Center, and the Department of Gastroenterology, General Hospital “Dr. Josip Kajfes”, Zagreb, Yugoslavia
,
B. Ugarković
1   From the Department of Nuclear Medicine, University Hospital Center, and the Department of Gastroenterology, General Hospital “Dr. Josip Kajfes”, Zagreb, Yugoslavia
,
D. Ivančević
1   From the Department of Nuclear Medicine, University Hospital Center, and the Department of Gastroenterology, General Hospital “Dr. Josip Kajfes”, Zagreb, Yugoslavia
,
D. Babić
1   From the Department of Nuclear Medicine, University Hospital Center, and the Department of Gastroenterology, General Hospital “Dr. Josip Kajfes”, Zagreb, Yugoslavia
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A method is presented which combines gastro-oesophageal reflux quantification and oesophageal transit measurement so as to differentiate true reflux from residual oesophageal activity. A group of 33 subjects with gastro-oesophageal reflux symptoms and endoscopically confirmed reflux oesophagitis and a group of 21 asymptomatic subjects with normal oesophageal, gastric and duodenal endoscopic findings were examined. The subjects were given 37 MBq 99mTc-Sn-colloid in saline orally and then scintiscanned dynamically. The gastro-oesophageal quantification was done after transit measurement and after the oesophageal time activity (to detect residual oesophageal activity) reached its minimum. The difference in the reflux indices between the two groups was highly significant. In low-grade oesophagitis measured reflux was lower than in higher grades of disease. Only 4.7% false-positive results were observed with a specificity of 95%, indicating that this method may be superior to methods published earlier.

Zusammenfassung

Es wird eine Methode beschrieben, die die Quantifizierung des gastroösophagealen Refluxes und die Messung des ösophagealen Transits kombiniert, um einen echten Reflux von restlicher Ösophagus-Aktivität zu unterscheiden. Untersucht wurden eine Gruppe von 33 Personen mit gastroösophagealen Reflux-Symptomen und endoskopisch bestätigter Reflux-Ösophagitis sowie eine Gruppe von 21 asymptomatischen Personen mit normalen ösophagogastrischen und duodenalen Befunden. Den Personen wurde oral 37 MBq 99mTc-Sn-Kolloid in Kochsalzlösung verabreicht, und es wurde eine dynamische Szintigraphie durchgeführt. Die gastroösophageale Quantifizierung wurde nach der Transitmessung, und nachdem die beobachteten ösophagealen Zeitaktivitätskurven (zur Entdeckung restlicher Ösophagus-Aktivität) ihr Minimum erreicht hatten, vorgenommen. Der Unterschied zwischen den Refluxindizes der beiden Gruppen war hoch signifikant. Bei geringerer Ösophagitis wurden niedrigere Reflux-Werte als bei höheren Krankheitsgraden beobachtet. Es gab nur 4,7% falsch-positive Ergebnisse mit einer Spezifität von 95%, so daß die vorgestellte Methode früher publizierten Methoden überlegen sein dürfte.



Publication History

Received: 30 April 1990

Publication Date:
04 February 2018 (online)

Schattauer GmbH

 

  • REFERENCES

  • 1 Clouse E R. Motor disorders. The oesophagus: anatomy, physiology, disease. In: Slesinger M H, Fordtran J S. Gastrointestinal disease. 4th ed.. Philadelphia - London-Toronto: Saunders; 1989: 559-88.
    Google Scholar
  • 2 Fisher R S, Malmud L S, Roberts G S, Lobis I A. Gastro-oesophageal (GE) scintiscanning to detect and quantitate GE reflux. Gastroenterology 1976; 03: 229.
    Google Scholar
  • 3 Fisher R S, Malmud L S, Roberts G S, Lobis I F. The lower oesophageal sphincter as a barrier to gastro-oesophageal reflux. Gastroenterology 1977; 72: 19.
    CrossrefPubMedGoogle Scholar
  • 4 Helm J F, Dodds W J, Pelc L R. et al. Effects of oesophageal emptying and saliva on clcarancc of acid from the oesophagus. N Engl J Med 1984; 02: 204.
    Google Scholar
  • 5 Hellemans J, Vantrapen G. Pathogenese der Oesophagitis und Refluxkrankheit. In: Blum A L, Sciwert J R. Reflux- therapic. Berlin - Heidelberg - New York: Springer; 1981: 66-84.
    Google Scholar
  • 6 Hoyoux C, Forget P, Grazaniti N, Godct A, Gcubellc F. Is the macroscopic aspect of the oesophagus at endoscopy indicative of reflux oesophagitis?. Endoscopy 1985; 18: 4.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Hogan W J, Wylie J D. Gestroocsophagcal reflux disease (Reflux oesophagitis). The oesophagus: anatomy, physiology and disease. In: Slesinger M H, Fordtran J S. Gastrointestinal disease. 4th ed/. Philadelphia - London - Toronto: Saunders; 1989: 594-616.
    Google Scholar
  • 8 Johnson L F. Gastro-oesophageal reflux diseases. Spitel J A. Clinical Medicine. Philadelphia: Harper and Row; 1984. 10 1-39
    Google Scholar
  • 9 Kaul B, Petersen H, Grete K, Erichsen H, Myrvold H E. Scintigraphy, H measurement and radiography in the evaluation of gastro-oesophageal reflux. Scand J Gastroenterol 1985; 20: 289.
    CrossrefPubMedGoogle Scholar
  • 10 Leisner B, Wirsching R, Seidel I. Osophagus-Funktionsszintigraphie: Kombinierte Untersuchung von Peristaltik und gastroösophagealem Reflux. NUC-Comp 1982; 13: 188.
    Google Scholar
  • 11 Miller G, Savary M, Monier P. Notwendige Diagnostik: Endoskopie. In: Blum L, Sciwert J P. Refluxthcrapie. Berlin - Heidelberg - New York: Springer; 1981: 336-54.
    Google Scholar
  • 12 Mughal M M, Marples M, Bancwicz J. Scintigraphic assessment of oesophageal motility: what does it show and how reliable it is. Gut 1986; 27: 946.
    CrossrefPubMedGoogle Scholar
  • 13 Paton J Y, Corgriff P S, Nanayakkara C S. The analytical sensitivity of 99mTc radionuclide “milk” scanning in the detection of gastro-oesophageal reflux. Pediatr Radiol 1985; 15: 381.
    CrossrefPubMedGoogle Scholar
  • 14 Petz B. Osnovnc statisticke mctode za nematcmatic are. 2nd ed.. Zagreb: SNL, 1985: 9-366.
    Google Scholar
  • 15 Royal H D, McNeil B J. Quantitative analysis in clinical nuclear medicine. In: Mascy M N, Briton K E, Gilday D L. Clinical nuclear medicine. London: Chapman and Hall; 1983: 457-79.
    Google Scholar
  • 16 Russell C OH, Hill L D, Holmes E R. et al. Radionuclide transit: a sensitive screening test for oesophageal dysfunction. Gastroenterology 1981; 80: 887.
    CrossrefPubMedGoogle Scholar
  • 17 Siebert J J, Byrne W J, Euler A R. et al. Gastrooesophagcal reflux - the acid test: scintigraphy or the pH probe?. Am J Radiol 1983; 140: 1087.
    Google Scholar
  • 18 Siegel S. Nonparametric statistics for the behavioral sciences. New York - Toronto - London: McGraw Hill; 1956: 1-283.
    Google Scholar
  • 19 Smith R B. Assessment of oesophageal function. In: Jewell D P, Selby W S. Topics in gastroenterology 10. London - Boston: Blackwell; 1982: 49-60.
    Google Scholar
  • 20 Stacher G. Oesophageal motility, oesophageal transit and gastro-oesophageal reflux - a method overview. Hepato-gastroentcrol 1985; 32: 229.
    Google Scholar
  • 21 Styles C B, Holt S, Bowes K L, Jewell L, Hooper H R. Gastro-oesophageal reflux and transit scintigraphy: a comparison with oesophageal biopsy in patients with heartburn. J Can Assoc Radiol 1984; 35: 124.
    PubMedGoogle Scholar
  • 22 Swanson M A, Cox K L, Cannon R A. Gastro-oesophageal scintigraphy with and without compression. Clin Nucl Med 1981; 06: 62.
    CrossrefPubMedGoogle Scholar
  • 23 Tolin R D, Malmud R S, Relley J, Fisher R S. Oesophageal scintigraphy to quantitate oesophageal transit (Quantitation of oesophageal transit). Gastroenterology 1979; 76: 1402.
    CrossrefPubMedGoogle Scholar
  • 24 Vanov B, Tadzer I S. Sequential scintiscanning of gastro-oesophageal reflux. Radiol Iugosl 1981; 15: 433.
    Google Scholar