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背景:在胃食管反流病(GERD)的诊断方法中,放射性核素检查与上消化道内镜检查、24 h食管pH监测、食管测压等相比,具有更符合生理情况且为非侵入性的优势。目的:探讨99mTc标记单光子发射计算机断层扫描(SPECT)对GERD的诊断价值。方法:糜烂性食管炎(EE)、非糜烂性反流病(NERD)和非心源性胸痛患者各10例纳入研究,入组患者反流性疾病问卷(RDQ)评分均>12分,质子泵抑制剂(PPI)试验阳性;10例无反流症状的志愿者作为对照组。受检者饮用99mTc标记的酸性饮料,以SPECT扫描食管区,观察胃食管连接处有无放射性出现;使用计算机按感兴趣区方法勾画胃、食管轮廓,计算反流指数。结果:EE组8例患者出现食管下端放射性,其中自发反流6例,诱发反流2例;NERD组和非心源性胸痛组相应数据分别为5例、3例、2例和6例、2例、4例。对照组均未见反流。三组研究组SPECT反流阳性率均显著高于对照组(80.0%、50.0%和60.0%对0%,P<0.05)。结论:99mTc标记SPECT对GERD具有显著诊断意义,有望作为GERD的常规检查项目在临床上开展。
BACKGROUND: In the diagnosis of gastroesophageal reflux disease (GERD), radionuclide tests are more physiologically relevant and non-invasive than upper gastrointestinal endoscopy, 24-h esophageal pH monitoring, and esophageal manometry Sexual advantages. Objective: To investigate the diagnostic value of 99mTc labeled single photon emission computed tomography (SPECT) for GERD. Methods: Ten patients with erosive esophagitis (EE), non-erosive reflux disease (NERD) and non-cardio-derived chest pain were enrolled in the study. The RDQ score of all patients was> 12 points. Proton Pump inhibitor (PPI) test was positive; 10 volunteers without reflux symptoms as control group. Subjects drinking 99mTc labeled acidic drinks, SPECT scanning esophageal area, to observe the gastroesophageal junction radioactivity; using computer according to the method of region of interest outline of the stomach, esophagus contour, calculate the reflux index. Results: There were 6 cases of spontaneous reflux and 2 cases of induced reflux in the 8 cases of EE group. The corresponding data of NERD group and non-cardiac chest pain group were 5 cases, 3 cases, 2 cases and 6 cases, respectively. 2 cases, 4 cases. No reflux in the control group. The positive rates of SPECT in three groups were significantly higher than those in the control group (80.0%, 50.0% and 60.0% vs 0%, P <0.05). Conclusion: 99mTc labeled SPECT has a significant diagnostic value for GERD and is expected to be clinically performed as a routine examination item of GERD.