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Clinical Investigations |
1 Gastroenterology Section, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania
2 Nuclear Medicine Section, Department of Diagnostic Imaging, Temple University School of Medicine, Philadelphia, Pennsylvania
3 Department of Computer and Information Sciences, Temple University, Philadelphia, Pennsylvania
The aim of this study was to develop a scintigraphic test to measure gastric emptying and accommodation simultaneously. Methods: Gastric emptying and accommodation were measured in healthy subjects. To determine gastric accommodation, the stomach was imaged with SPECT 20 min after intravenous administration of 185 MBq (5 mCi) 99mTc-pertechnetate. After ingestion of 11 MBq (300 µCi) 111In-diethylenetriaminepentaacertic acid in a liquid nutrient drink or an 111In-oxine–labeled egg sandwich, dual-isotope imaging assessed SPECT gastric dimensions and gastric emptying every 20 min up to 240 min. Gastric accommodation was calculated as the percentage change in planar (2-dimensional) gastric cross-sectional area (CSA) using a left anterior oblique planar projection and the percentage change in total SPECT gastric voxel counts (3-dimensional) compared with the baseline image. Results: With the liquid nutrient drink (9 subjects), maximal mean CSA (158% ± 12% of baseline; P < 0.05) occurred 40 min after meal ingestion, when only 69% ± 3% of the radiolabeled liquid nutrient drink remained in the stomach. At 120 min, mean CSA was 125% ± 8% of baseline, but only 35% ± 3% of the liquid nutrient drink remained in the stomach. Using SPECT to measure 3-dimensional volumes, maximal gastric volume occurred 20 min after meal ingestion (189% ± 25% of baseline). With the solid egg meal (10 subjects), maximal total CSA (159% ± 13% of baseline) occurred immediately after meal ingestion; total CSA remained significantly increased above baseline for the first 3 h after ingestion of the egg meal, despite only 12% ± 4% gastric retention at 3 h. Using SPECT to measure 3-dimensional volumes, maximal gastric volume occurred immediately after the meal (184% ± 19% of baseline). Conclusion: This method permits simultaneous measurement of gastric emptying and accommodation. In healthy subjects, the gastric accommodation response is prolonged and persists despite nearly complete emptying of a liquid or solid meal.
Key Words: gastric accommodation • gastric emptying • functional dyspepsia
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