Diagnostic Value of 99m Tc-labeled SPECT for Gastroesophageal Reflux Disease / 胃肠病学

ABSTRACT

Background:Of the diagnostic modalities of gastroesophageal reflux disease( GERD),radioisotopic examination is more physiological and non-invasive as compared with upper gastrointestinal endoscopy,24-hour esophageal pH monitoring and esophageal manometry. Aims:To examine the diagnostic value of 99m Tc-labeled single-photon emission-computed tomography(SPECT)for GERD. Methods:Ten erosive esophagitis(EE),10 nonerosive reflux disease(NERD)and 10 noncardiac chest pain patients were enrolled in this study. All of them had a high reflux disease questionnaire( RDQ)score (>12)and were positive for proton pump inhibitor(PPI)test. Ten volunteers without reflux symptoms served as controls. After the taking of 99mTc-labeled acidic drinks,SPECT scan was performed in esophageal region for indentifying the radioactivity at gastroesophageal junction. Through region-of-interest,the stomach and esophagus were outlined and the GERindex was calculated. Results:Radioactivity was observed in lower esophagus in 8 patients of EE group,including 6 spontaneous reflux and 2 induced reflux;in NERD group and noncardiac chest pain group,the corresponding data were 5,3, 2 and 6,2,4,respectively. No reflux was observed in control group. Positivity rates of reflux identified by SPECT in EE, NERD and noncardiac chest pain groups were all significantly higher than that in control group(80. 0%,50. 0% and 60. 0%vs. 0%,P<0. 05). Conclusions:99m Tc-labeled SPECT has clinical value for diagnosis of GERD and is potential for being used as a method of GERD examination in clinical practice.