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Journal of Nuclear Medicine

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Research ArticleGastroenterology

Experience with Esophagogastrointestinal Transit Scintigraphy in the Initial 229 Patients: Multiple Regions of Dysmotility Are Common

Harvey A. Ziessman, Mathurika Jeyasingam, Ahsan U. Khan, Zsuzsanna McMahan and Pankaj J. Pasricha
Journal of Nuclear Medicine January 2021, 62 (1) 115-122; DOI: https://doi.org/10.2967/jnumed.120.243527
Harvey A. Ziessman
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Mathurika Jeyasingam
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Ahsan U. Khan
2Department of Radiology, West Virginia University, Morgantown, West Virginia
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Zsuzsanna McMahan
3Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
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Pankaj J. Pasricha
4Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Abstract

The purpose of this investigation was to review our experience with our comprehensive esophagogastrointestinal transit study in the first 229 patients. This scintigraphic study analyzes the motility of the entire gut, from the esophagus through the rectosigmoid colon. Methods: Data were reviewed for our first 2 y of experience with this examination (184 women and 45 men aged 20–79 y [mean ± SD, 44 ± 16 y]). Patients were referred with symptoms suggestive of a motility disorder. They first swallowed 111In-diethylenetriaminepentaacetic acid in water for the esophageal-swallow study and then 300 mL for a 30-min 111In water-only study, followed by 120 mL of 111In water simultaneously with the solid standardized 99mTc egg-substitute meal. Images and quantification were obtained for esophageal transit, water-only gastric emptying, water-with-solid gastric emptying, small-bowel transit, and colonic transit. Results: Of the 229 patient studies, 45 (20%) were normal. The remaining 184 (80%) had at least 1 region of dysmotility, for a total of 336 regions of abnormal motility. A single region of dysmotility was seen in 92 patients (50%), 2 regions in 50 (27%), 3 regions in 26 (14%), 4 regions in 12 (7%), and 5 regions in 4 (2%). There was a poor correlation between the results of the water-only study and water with the solid meal. Three different patterns of delayed colonic transit were seen. Patient symptoms were often not predictive of the scintigraphic findings. Conclusion: This study highlights the frequent occurrence of dysmotility in more than 1 region of the gastrointestinal tract in patients with a suspected motility disorder and the frequent concurrence of both upper- and lower-tract dysmotility in the same patients. It provides information to referring physicians regarding which motility disorders may be causing the patient symptoms, why the patient is or is not responding to the present therapy, and if and what additional workup and therapy may be needed.

  • gastric scintigraphy
  • gastrointestinal transit
  • intestinal transit scintigraphy

Footnotes

  • Published online Jun. 1, 2020.

  • © 2021 by the Society of Nuclear Medicine and Molecular Imaging.
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Journal of Nuclear Medicine: 62 (1)
Journal of Nuclear Medicine
Vol. 62, Issue 1
January 1, 2021
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Experience with Esophagogastrointestinal Transit Scintigraphy in the Initial 229 Patients: Multiple Regions of Dysmotility Are Common
Harvey A. Ziessman, Mathurika Jeyasingam, Ahsan U. Khan, Zsuzsanna McMahan, Pankaj J. Pasricha
Journal of Nuclear Medicine Jan 2021, 62 (1) 115-122; DOI: 10.2967/jnumed.120.243527

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Experience with Esophagogastrointestinal Transit Scintigraphy in the Initial 229 Patients: Multiple Regions of Dysmotility Are Common
Harvey A. Ziessman, Mathurika Jeyasingam, Ahsan U. Khan, Zsuzsanna McMahan, Pankaj J. Pasricha
Journal of Nuclear Medicine Jan 2021, 62 (1) 115-122; DOI: 10.2967/jnumed.120.243527
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Keywords

  • gastric scintigraphy
  • gastrointestinal transit
  • intestinal transit scintigraphy
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