Dynamic esophageal scintigraphy for detection of esophageal motility disorders – practical aspects
Authors:
Drahoslava Nováková; Vladimír Dedek
Authors‘ workplace:
Klinika nukleární medicíny, FN Ostrava
Published in:
NuklMed 2014;3:67-73
Category:
Review Article
Overview
Introduction:
Dynamic esophageal scintigraphy (DES) is a functional diagnostic test which analyses a transit of a bolus of a radiopharmaceutical (RP) through the esophagus to the stomach. Evaluation of esophageal motility is useful in a series of pathologies in adults as well as children after an organic disease is excluded. The most frequent indication is a suspicion to the peristalsis disorder including malfunction of the lower esophageal sphincter in esophageal reflux disease (ERD), less frequent indication is evaluation of patients with autoimmune systemic diseases, diabetics etc.
Methods:
3 to 6 hours npo, prokinetics withdrawal for 48 hours, supine position, detector above the thorax. Technologist trains swallowing of appropriate volume of RP – adults 10 ml, children 5 ml. The patient then swallows the bolus of a RP (20 to 50 MBq of 99mTc MAA) and the dynamic study begins: 1st group – 240 frames 120 ms each; 2nd group – 120 frames 15 sec each. We draw regions of interest (ROI) above individual thirds of the esophagus and above the stomach. We evaluate mean transit time (MTT), antiperistalsis or retention of RP in the esophagus from the first group after dynamic curves are created. Gastroesophageal reflux (GER) presence is evaluated form the second group.
Results:
We present examples of antiperistalsis, prolonged MTT, retention and GER in ERD, bronchial asthma, chronic cough, sclerodermia and achalasia.
Conclusion:
DES is a simple, functional, non-invasive diagnostic test with a low radiation, which has a high sensitivity for the detection of esophageal motility disorder. It gives additional functional information as the organic disease is excluded. It is useful also in children. It can also be used for better control of the treatment.
Key words:
dynamic esophageal scintigraphy, mean transit time, antiperistalsis, gastroesophageal reflux, esophageal reflux disease
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Nuclear Medicine
2014 Issue 4
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