Proposal of a modified scintigraphic method to evaluate duodenogastroesophageal reflux.
Hepatobiliary scintigraphy with 99mTc-HIDA offers a noninvasive method to detect duodenogastric reflux. Biliary reflux was graded using the persistence rather than the intensity of the radioactive refluxate: Grade 0 was considered the absence of reflux, minimal reflux, or reflux in the first 10-15 min; Grade 1 was repetitive reflux lasting less than 10 min; Grade 2 was persistent reflux; and Grade 3 was reflux up to the esophagus. Twenty-five patients with foregut symptoms were studied and results were compared to 24-hr gastric pH monitoring. Scintigraphy and pH monitoring agreed in 15 out of 25 patients (60%), but no correlation was found with the endoscopic findings. The rationale for this approach is based on pathophysiologic evidence that damage to gastric and/or esophageal mucosa is mainly related to the prolonged contact time with duodenal contents. This technique seems to allow a complete functional evaluation of the esophagogastroduodenal tract without causing adjunctive irradiation or discomfort to the patient.
Borsato
N
N
Division of Nuclear Medicine, Castelfranco Veneto Hospital, Italy.
Bonavina
L
L
Zanco
P
P
Saitta
B
B
Chierichetti
F
F
Peracchia
A
A
Ferlin
G
G
D000328:Adult; D000368:Aged; D004383:Duodenogastric Reflux / Q000000981:diagnostic imaging*; D005260:Female; D005750:Gastric Juice; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007098:Imino Acids; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D019780:Technetium Tc 99m Lidofenin; D013997:Time Factors
D007098:Imino Acids; D015609:Organotechnetium Compounds; D019780:Technetium Tc 99m Lidofenin