Enterogastric bile reflux during technetium-99m-sestamibi cardiac imaging.
Enterogastric bile reflux (EGBR), a risk factor for both gastritis and esophagitis, is a potentially treatable noncoronary cause for chest pain.


METHODS
To investigate the frequency of EGBR during different 99mTc-sestamibi cardiac imaging, 1405 consecutive 99mTc-sestamibi SPECT myocardial perfusion studies were reviewed.


RESULTS
One hundred sixteen of the 1405 patient studies (8.3%) showed EGBR with roughly equal numbers of patients having marked (43 patients), moderate (38 patients) or minimal (35 patients) intensity of abnormal gastric activity. Two examinations showed gastroesophageal reflux of activity. EGBR was less frequent with treadmill stress testing (5.5% patients) than with pharmacologic stress testing using either dipyridamole (11% of patients) or dobutamine (9.2% of patients) (p > 0.005). EGBR also was more frequent in patients over 40 yr of age. Finally, the prevalence of upper gastrointestinal symptoms and the frequency of established upper gastrointestinal diagnoses correlated strongly with the presence and intensity of EGBR.


CONCLUSIONS
Clarification of the full clinical significance of EGBR during 99mTc-sestamibi cardiac imaging is a topic for future research. Nonetheless, the imaging finding of EGBR may, in fact, identify a potentially treatable noncoronary cause for chest pain.
Kabasakal
L
L
Department of Radiology, Medical College of Wisconsin, Milwaukee, USA.
Collier
B D
BD
Shaker
R
R
Hellman
R S
RS
Smart
S
S
Ozker
K
K
Krasnow
A Z
AZ
Isitman
A T
AT
D001655:Bile Reflux / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D016022:Case-Control Studies; D002637:Chest Pain / Q000209:etiology*; D003327:Coronary Disease / Q000000981:diagnostic imaging; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents
D014665:Vasodilator Agents; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi