Is scintigraphy of value in the diagnosis of gastrooesophageal reflux disease?
One hundred and ten patients with suspected oesophageal symptoms were investigated by means of oesophageal endoscopy (OE), 24-h pH-metry, and oesophageal scintigraphy (ES). When 24-h pH-metry formed the basis for diagnosis of gastrooesophageal reflux disease (GERD), the sensitivity for ES at abdominal compression was 64%, but no statistically significant differences were found among erect refluxers (ER), supine refluxers (SR), and combined refluxers (CR). Only 4% of the GERD patients had pathologic oesophageal clearing at ES. The more severe the macroscopic oesophagitis found by OE, the more pronounced were the abnormal findings at 24-h pH-metry and at ES with abdominal compression. Increased postprandial reflux was associated with gastro-oesophageal reflux and hiatal hernia at ES with abdominal compression and the most severe form of oesophagitis, respectively. It was concluded that ES had too low sensitivity to be recommended as a screening test for GERD. Nevertheless, the specificity of 76% can to some extent help us to rule out GERD in patients.
Kjellén
G
G
ENT Dept., Centrallasarettet, Kalmar, Sweden.
Brudin
L
L
Håkansson
H O
HO
D000293:Adolescent; D000328:Adult; D000368:Aged; D016099:Endoscopy, Gastrointestinal; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging