title: Measurement of gastric emptying of a high-nutrient liquid by 3D ultrasonography in diabetic gastroparesis.
abstract: BACKGROUND
  Gastric emptying (GE) is delayed in 30-50% of patients with longstanding diabetes. Scintigraphy represents the 'gold standard' for measurement of GE, but is associated with a radiation burden. Three-dimensional (3D) ultrasonography has recently been demonstrated to provide a valid measure of liquid GE in healthy subjects; however, the technique has not been validated in patients with gastroparesis. The primary aim of this study was to compare measurements of GE of a high-nutrient glucose drink by 3D ultrasonography and scintigraphy in diabetic gastroparesis.
  
  
  METHODS
  Ten patients (eight type 1, two type 2, 6M, 4F, aged 46.1 ± 4.5 years, BMI 29.1 ± 1.6 kg m(-2), duration 19.6 ± 3.3 years) with diabetic gastroparesis [defined as retention at 100 min of solid (100 g minced beef) ≥ 61% and/or 50% emptying time (T50) of liquid (150 mL 10% dextrose) ≥ 31 min], were studied. Concurrent measurements of GE by scintigraphy and 3D ultrasonography were performed following ingestion of 75 g glucose in 300 mL water labeled with 20 MBq (99m) Tc-sulfur colloid.
  
  
  RESULTS
  There was no significant difference in GE between the two techniques (T50s: scintigraphy - 103.3 ± 10.0 min VS 3D ultrasonography - 98.8 ± 10.4 min; P = 0.60). There was a significant correlation between scintigraphic and ultrasonographic T50s (r = 0.67, P = 0.03). The limits of agreement for the T50s were -57.22 min and +48.22 min (mean difference -4.5 min). Blood glucose after the drink was greater when GE was relatively more rapid (e.g. at t = 60 min; scintigraphy: r = -0.65, P = 0.04; 3D ultrasonography: r = -0.78, P = 0.008).
  
  
  CONCLUSIONS
  Three-dimensional ultrasonography appears to provide a valid, and non-invasive, measure of GE of high-nutrient liquids in diabetic gastroparesis.
authors.affiliation: Discipline of Medicine, Royal Adelaide Hospital, University of Adelaide, Adelaide, Australia.
authors.forename: J E
authors.initials: JE
authors.lastname: Stevens
authors.forename: O H
authors.initials: OH
authors.lastname: Gilja
authors.forename: D
authors.initials: D
authors.lastname: Gentilcore
authors.forename: T
authors.initials: T
authors.lastname: Hausken
authors.forename: M
authors.initials: M
authors.lastname: Horowitz
authors.forename: K L
authors.initials: KL
authors.lastname: Jones
mesh_terms: D000328:Adult; D001628:Beverages; D001786:Blood Glucose / Q000378:metabolism; D003929:Diabetic Neuropathies / Q000150:complications* / Q000503:physiopathology*; D004435:Eating; D005260:Female; D005502:Food; D005746:Gastric Emptying / Q000502:physiology*; D018589:Gastroparesis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography
chemical_list: D001786:Blood Glucose