Value and role of esophageal scintigraphy in the diagnosis of gastroesophageal reflux in infants and children
Le Luyer, B.; Texte, D.; Segond, G.; Mallet, E.; de Menibus, C.H.
Pediatrie 38(5): 291-302
1983
ISSN/ISBN: 0031-4021 PMID: 6646943 Document Number: 200644
There were 50 children with a strong clinical suspicion of gastrooesophageal reflux and 10 controls patients evaluated with gastrooesophageal scintiscans. 500 microCi to 1 mCi of Tc sulfur colloïd mixed the patients routine milk or formula feeding was administered and serial images of the abdomen and thorax were obtained. A positive scintiscan was found in 35 patients (sensitivity 70 %) and none of the controls (specificity 100 %). A comparison of findings in 34 patients referred for both radiographic and radionuclide studies showed that barium studies were positive in 38 % and radionuclide in 64,7 %. We found this examination to be more sensitive that the standard barium radiography particularly in patients with respiratory symptoms. We conclude that the GE scintiscan is complementary to barium studies in the diagnosis of GE reflux. Pulmonary aspiration of gastric contents was detected in only a case of the 35 patients with documented GE reflux. A T 1/2 emptying gastric more long that 90 minutes (linear calculationation) or 115 minutes (exponential calcul) is an indirect GE reflux test. The diagnostic accuracy of all various procedures is reviewed and the scintigraphy value in the evaluation of GER in infants and children is discussed. This method is simple, safe more physiologic than other available examinations.