Dynamic scintigraphy of the oesophagus in the diagnostics of gastro-oesophageal reflux disease

Česká verzia

Authors: V. Dedek; V. Ullmann
Authors place of work: Klinika nukleární medicíny, FN Ostrava-Poruba
Published in the journal: Gastroent Hepatol 2011; 65(1): 15-21
Category: Clinical and Experimental Gastroenterology: Original Article

Summary

Gastro-oesophageal reflux disease (GERD) is characterized by the predominance of aggressive influences on the protective mechanisms of the oesophagus. One of the main factors in oesophageal mucosa purification is the normal functioning of the oesophagus, which can be qualitatively and quantitatively assessed by radionuclide oesophageal transit study (RETS). We analyzed the results of RETS in a group of 47 patients with gastro-oesophageal symptoms. Compared with normal values for the control group (45 persons) we quantified oesophageal mean transit time (MTT), antiperistalsis, retention in the oesophagus and signs of gastro-oesophageal reflux (GER). Findings were normal for 29 (62%) of the group of 47 patients. The rest (18 patients – 38%) had at least one parameter of oesophageal function with pathological values. We observed signs of GER in only one case. RETS is a simple, safe, non-invasive method using a low amount of radiation, and which takes place under physiological conditions. We are of the opinion that information on the status of oesophageal peristalsis is beneficial for people with suspected GERD – even in patients with already proven oesophagitis or positive pH metrics. This chiefly concerns cases of the failure of antisecretion therapy, where the use of prokinetic agents may lead to a desirable therapeutic effect. On the other hand, the scintigraphic detection of GER has a limited informational value due to its short monitoring period (30 minutes). Consequently, the appearance of GER then requires verification by indication of other diagnostic methods, e.g. pH metrics or the measurement of oesophageal impedance.

Key words:
gastro-oesophageal reflux – radionuclide oesophageal transit study – mean transit time – antiperistalsis – retention

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