Thomforde G M, Camilleri M, Phillips S F, Forstrom L A
Gastroenterology Research Unit, Mayo Clinic, Rochester, MN 55905.
J Nucl Med. 1995 Jan;36(1):93-6.
Our goal was to study the accuracy of a limited assessment relative to the traditional and obtain a more detailed approach to measure gastric emptying.
We prospectively evaluated 35 patients referred to our laboratory with suspected fast or slow gastric emptying. Transit was measured radioscintigraphically after ingestion of an egg meal containing 99mTc-Amberlite pellets. Gastric emptying was analyzed by power exponential analysis. Diagnostic accuracy of simpler indices (gastric residual at 2 and 4 hr) was determined by comparing the categorization of patients as normal or abnormal relative to previously published normal data from our laboratory.
Gastric residual at 2 hr showed greater diagnostic accuracy for accelerated gastric emptying with 90% sensitivity at 90% specificity. Gastric residual at 4 hr was less accurate for accelerated emptying, but was more accurate at detecting delayed gastric emptying with 100% sensitivity at 70% specificity. In contrast, sensitivity and specificity of gastric residual at 2 hr for slow emptying were low (100% sensitivity with 20% specificity) emphasizing the importance of obtaining a scan later than 2 hr for detecting delayed gastric emptying.
Selective scans taken at 2 and 4 hr provide an excellent screening test for detecting fast or slow gastric emptying; the accuracy of 2-hr data is optimal for accelerated emptying and that of the 4-hr data greater for delayed emptying. This strategy provides a simple, less expensive way to evaluate gastric emptying in clinical practice with acceptable sensitivity and specificity as an initial test for patients with clinically suspected gastric stasis or dumping syndromes.
我们的目标是研究相对于传统评估方法的有限评估的准确性，并获得一种更详细的方法来测量胃排空。
我们前瞻性地评估了35名因怀疑胃排空过快或过慢而转诊至我们实验室的患者。在摄入含有99mTc- Amberlite颗粒的蛋餐后，通过放射性核素闪烁扫描法测量转运情况。通过幂指数分析来分析胃排空情况。通过将患者分类为正常或异常与我们实验室先前公布的正常数据进行比较，来确定更简单指标（2小时和4小时时的胃残余量）的诊断准确性。
2小时时的胃残余量对胃排空加速显示出更高的诊断准确性，在特异性为90%时敏感性为90%。4小时时的胃残余量对排空加速的准确性较低，但在检测胃排空延迟方面更准确，特异性为70%时敏感性为100%。相比之下，2小时时胃残余量对排空延迟的敏感性和特异性较低（敏感性为100%，特异性为20%），这强调了在2小时后进行扫描以检测胃排空延迟的重要性。
在2小时和4小时进行的选择性扫描为检测胃排空过快或过慢提供了一种出色的筛查测试；2小时数据的准确性对于排空加速最为理想，4小时数据对于排空延迟更为理想。这种策略提供了一种简单、成本较低的方法，在临床实践中以可接受的敏感性和特异性来评估胃排空，作为对临床怀疑有胃潴留或倾倒综合征患者的初始测试。
