Le Luyer B, Texte D, Segond G, Mallet E, de Menibus C H
Pediatrie. 1983 Jul-Aug;38(5):291-302.
There were 50 children with a strong clinical suspicion of gastrooesophageal reflux and 10 controls patients evaluated with gastrooesophageal scintiscans. 500 microCi to 1 mCi of Tc sulfur colloïd mixed the patients routine milk or formula feeding was administered and serial images of the abdomen and thorax were obtained. A positive scintiscan was found in 35 patients (sensitivity 70 %) and none of the controls (specificity 100 %). A comparison of findings in 34 patients referred for both radiographic and radionuclide studies showed that barium studies were positive in 38 % and radionuclide in 64,7 %. We found this examination to be more sensitive that the standard barium radiography particularly in patients with respiratory symptoms. We conclude that the GE scintiscan is complementary to barium studies in the diagnosis of GE reflux. Pulmonary aspiration of gastric contents was detected in only a case of the 35 patients with documented GE reflux. A T 1/2 emptying gastric more long that 90 minutes (linear calculationation) or 115 minutes (exponential calcul) is an indirect GE reflux test. The diagnostic accuracy of all various procedures is reviewed and the scintigraphy value in the evaluation of GER in infants and children is discussed. This method is simple, safe more physiologic than other available examinations.
对50名临床高度怀疑患有胃食管反流的儿童和10名对照患者进行了胃食管闪烁扫描评估。将500微居里至1毫居里的锝硫胶体与患者日常的牛奶或配方奶混合后喂食,然后获取腹部和胸部的系列图像。35名患者的闪烁扫描结果呈阳性(敏感性为70%),而对照患者均为阴性(特异性为100%)。对34名同时接受了放射造影和放射性核素检查的患者的检查结果进行比较发现,钡餐检查阳性率为38%,放射性核素检查阳性率为64.7%。我们发现这项检查比标准钡餐造影更敏感,尤其是对有呼吸道症状的患者。我们得出结论,胃食管闪烁扫描在胃食管反流的诊断中是对钡餐检查的补充。在35名有记录的胃食管反流患者中,仅1例检测到胃内容物的肺部误吸。胃排空半衰期超过90分钟(线性计算)或115分钟(指数计算)是一种间接的胃食管反流检测方法。本文回顾了所有各种检查方法的诊断准确性,并讨论了闪烁扫描在评估婴幼儿胃食管反流中的价值。这种方法简单、安全,比其他现有检查更符合生理情况。