Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Parkinson Pavilion, 8th floor, Philadelphia, PA, 19140, USA.
Section of Nuclear Medicine, Department of Radiology, Temple University, Philadelphia, PA, USA.
Dig Dis Sci. 2024 Oct;69(10):3875-3881. doi: 10.1007/s10620-024-08564-w. Epub 2024 Aug 2.
Whole gut transit scintigraphy (WGTS) can detect delayed colonic transit (CT), different types of CT delays, and assess upper GI tract transit.
To delineate the frequency of different types of CT patterns in patients with chronic constipation (CC), determine the relationship between these CT patterns and upper GI tract transit abnormalities, and assess how symptoms relate to different colonic transit patterns.
Retrospective review of patients who had WGTS for CC. Patients completed a modified PAGI-SYM questionnaire to assess symptoms. Patients ingested a standard solid (Tc-99m egg sandwich)-liquid (In-111 water) meal to assess solid meal gastric emptying (GE), liquid GE, small bowel transit (SBT), and geometric center of colonic activity at 24, 48, and 72h.
One hundred and eighty six patients underwent WGTS. Main symptoms were constipation (41%), nausea (24%), and bloating (22%). CT assessment showed 32% of patients had normal transit, 31% colonic inertia (CI), 28% functional rectosigmoid obstruction (FRS0), and 9% generalized slow colonic transit (GSCT). GE was delayed in 36%; more commonly in CI and FRSO. SBT was delayed in 19%; more commonly in GSCT and CI. Patients with CI had less bowel movements per week whereas patients with normal CT had more bm/week.
In this series of patients with symptomatic constipation, WGTS assessment showed delayed colonic transit in 68% of patients, with 31% having colonic inertia, 28% a functional rectosigmoid obstruction pattern, and 9% generalized delay in colonic transit. Abnormalities in GE and SBT were present in 36 and 19%. WGTS is helpful to document delayed colonic transit (CT), assess the pattern of the delay in CT, and determine if there are upper GI transit abnormalities.
全肠道通过闪烁显像术（WGTS）可检测结肠传输延迟（CT）、不同类型的 CT 延迟，并评估上胃肠道传输。
描绘慢性便秘（CC）患者中不同类型 CT 模式的频率，确定这些 CT 模式与上胃肠道传输异常之间的关系，并评估不同结肠传输模式与症状之间的关系。
回顾性分析接受 WGTS 检查以诊断 CC 的患者。患者完成改良 PAGI-SYM 问卷以评估症状。患者摄入标准固体（Tc-99m 鸡蛋三明治）-液体（In-111 水）餐，以评估固体餐胃排空（GE）、液体 GE、小肠传输（SBT）和 24、48 和 72 小时时的结肠活动几何中心。
186 例患者接受了 WGTS 检查。主要症状为便秘（41%）、恶心（24%）和腹胀（22%）。CT 评估显示，32%的患者传输正常，31%的患者存在结肠惰性（CI），28%的患者存在功能性直肠乙状结肠梗阻（FRS0），9%的患者存在广泛性结肠传输缓慢（GSCT）。36%的患者 GE 延迟，更常见于 CI 和 FRSO。19%的患者 SBT 延迟，更常见于 GSCT 和 CI。CI 患者每周排便次数较少，而 CT 正常的患者每周排便次数较多。
在这一系列有症状的便秘患者中，WGTS 评估显示 68%的患者存在结肠传输延迟，31%的患者存在结肠惰性，28%的患者存在功能性直肠乙状结肠梗阻模式，9%的患者存在广泛性结肠传输延迟。36%的患者存在 GE 和 SBT 异常。WGTS 有助于记录结肠传输延迟（CT），评估 CT 延迟的模式，并确定是否存在上胃肠道传输异常。
