Abdelnaem Nada, Camilleri Michael, Bartlett David J
Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Division of Nuclear Medicine, Department of Radiology Mayo Clinic, Rochester, MN, USA.
Expert Rev Gastroenterol Hepatol. 2024 Nov;18(11):713-723. doi: 10.1080/17474124.2024.2434592. Epub 2024 Dec 3.
Advancements in scintigraphic gastrointestinal motility testing that were developed, validated, and replicated in clinical practice at Mayo Clinic have significantly enhanced our understanding and management of gastrointestinal motility disorders. Importantly, normative values in at least 100 healthy controls and estimated inter- and intra-individual coefficient of variation for all parameters have been published for these tests.
This article reviews methodology, accuracy, reproducibility, and diagnostic cutoffs of scintigraphic techniques for measuring gastric emptying, gastric accommodation, and colonic transit, comparing methods from Mayo Clinic with those used elsewhere when appropriate. The review used PubMed and Google Scholar from inception to August 2024, utilizing relevant keywords.
In our view, scintigraphic testing with high standards of validation, reproducibility, and robust normal control data is required, including the choice of the composition of the meal for gastric emptying of solids. The utility of the distribution of isotope in the proximal and distal stomach as a measurement of accommodation, a vegan meal for gastric emptying measurement, and the use of orally administered radiolabeled liquid to measure colonic transit are promising methods requiring further validation. It is necessary for organizations to develop guidelines on optimizing scintigraphic gut motility measurement.
在梅奥诊所临床实践中开发、验证并重复应用的闪烁扫描胃肠动力检测技术取得的进展,显著增进了我们对胃肠动力障碍的理解和管理。重要的是,这些检测已公布了至少100名健康对照者的正常参考值以及所有参数的个体间和个体内变异系数估计值。
本文回顾了用于测量胃排空、胃容纳功能和结肠传输的闪烁扫描技术的方法、准确性、可重复性和诊断临界值,并在适当情况下将梅奥诊所的方法与其他地方使用的方法进行比较。本综述使用了从创刊到2024年8月的PubMed和谷歌学术搜索,使用了相关关键词。
我们认为,需要进行高标准验证、可重复性且有可靠正常对照数据的闪烁扫描检测,包括固体胃排空餐食成分的选择。将近端和远端胃内同位素分布作为容纳功能的测量指标、使用素食餐测量胃排空以及口服放射性标记液体测量结肠传输等方法很有前景,但需要进一步验证。各机构有必要制定优化闪烁扫描肠道动力测量的指南。