Orenstein S R, Klein H A, Rosenthal M S
Department of Pediatrics, University of Pittsburgh School of Medicine, Pennsylvania.
J Nucl Med. 1993 Aug;34(8):1228-34.
We performed 12 simultaneous scintigraphic and pH probe studies in children being evaluated for reflux to determine the ability of scintigraphic images in comparison to pH probe data to quantify gastroesophageal reflux in children and to identify an optimal scintigraphic framing interval. We used a multiplexor to synchronize exactly the scintigraphy and pH probe and an acid meal to avoid missing postprandial episodes with the pH probe. We reformatted the studies in both 60-sec and 10-sec images to compare the two framing intervals. The 60-sec images produced better agreement between pH probe and scintigraphy than the 10-sec images for both the number of reflux episodes and the duration of reflux. Of the 64 reflux episodes detected by either method at this coarser framing interval, scintigraphy detected 80%, the pH probe detected 63% and both methods concurrently detected 42%. Of the 681 60-sec images aggregated across patients, scintigraphy detected 55% of those with intraesophageal refluxate, the pH probe detected 96% and both tests concurrently detected 51%. Within patients, the number of positive scintigraphic images in the postprandial hour correlated with the number of images with pH < 4 during the same hour (p = 0.008, and p < 0.0001 if two patients with very rapid gastric emptying are excluded), but not with the results of the 24-hr pH probe study. A 1-hr scintigraphic study formatted in 60-sec frames provides a quantitative representation of postprandial gastroesophageal reflux for children, particularly if they do not have rapid gastric emptying.
我们对因反流接受评估的儿童进行了12项同时进行的闪烁扫描和pH值探头研究，以确定闪烁扫描图像与pH值探头数据相比，在量化儿童胃食管反流以及确定最佳闪烁扫描成像间隔方面的能力。我们使用多路复用器精确同步闪烁扫描和pH值探头，并给予试餐，以避免pH值探头遗漏餐后发作。我们将研究重新格式化为60秒和10秒图像，以比较这两种成像间隔。对于反流发作次数和反流持续时间，60秒图像在pH值探头和闪烁扫描之间产生的一致性比10秒图像更好。在这个较粗成像间隔下，两种方法检测到的64次反流发作中，闪烁扫描检测到80%，pH值探头检测到63%，两种方法同时检测到42%。在汇总的681张60秒患者图像中，闪烁扫描检测到55%的食管内有反流物的图像，pH值探头检测到96%，两种检测同时检测到51%。在患者内部，餐后1小时内闪烁扫描阳性图像的数量与同一小时内pH值<4的图像数量相关（p = 0.008，如果排除两名胃排空非常快的患者则p < 0.0001），但与24小时pH值探头研究结果无关。以60秒帧格式进行的1小时闪烁扫描研究可为儿童餐后胃食管反流提供定量表示，特别是对于胃排空不迅速的儿童。
