Abstract：
OBJECTIVE: Measurements of gastric emptying and accommodation for alternative test-meal protocol during gastric emptying scintigraphy (GES), such as high-calorie nutrient drinks, are not fully established. We aimed to compare the effects of standardized egg-white meal (EWM) versus high-calorie nutrient drink (Vital®; Abbott Laboratories) on global GES parameters and intragastric meal distribution at immediate scan (IMD0h).
METHODS: Of 84 screened participants, 60 asymptomatic healthy Asian population (38 females; 24.0 ± 1.5 years; 23.8 ± 2.6 kg/m2) were recruited in this 2 × 2 (AB/BA) crossover trial. Participants were randomized to a 4-h GES with 99mTc-radiolabeled EWM (~255.8 kcal), followed by a 200 mL Vital® (300 kcal), or vice versa, separated by a 2-week washout period. Global meal retention (GMR), power-exponential model emptying parameters (half-emptying [T1/2], lag phases [Tlag2%, Tlag5%, Tlag10%]), and IMD0h were determined and compared.
RESULTS: GMRs for both test meals were within the international standard references for solid GES. Compared to EWM, Vital® exhibited significantly lower GMRs (faster emptying) from 0.5 to 3 h (all P < 0.001) but comparable at 4 h (P = 0.153). Similar observations were found for the model-based T1/2 and the different Tlag thresholds (all P < 0.001). Furthermore, IMD0h was found to be lower with Vital®, indicating lower gastric accommodation (faster antral filling) immediately post-ingestion (P < 0.001). Both test meals showed significant moderate-to-strong positive associations at the late-phase GE (GMR 2-4 h, T1/2) (all P < 0.05).
CONCLUSIONS: Overall, Vital® is an acceptable alternative test meal to the EWM for GES; however, exercise caution when interpreting early-phase GE. The normative values for global GES parameters and IMD0h are also established.
METHODS: Of 84 screened participants, 60 asymptomatic healthy Asian population (38 females; 24.0 ± 1.5 years; 23.8 ± 2.6 kg/m2) were recruited in this 2 × 2 (AB/BA) crossover trial. Participants were randomized to a 4-h GES with 99mTc-radiolabeled EWM (~255.8 kcal), followed by a 200 mL Vital® (300 kcal), or vice versa, separated by a 2-week washout period. Global meal retention (GMR), power-exponential model emptying parameters (half-emptying [T1/2], lag phases [Tlag2%, Tlag5%, Tlag10%]), and IMD0h were determined and compared.
RESULTS: GMRs for both test meals were within the international standard references for solid GES. Compared to EWM, Vital® exhibited significantly lower GMRs (faster emptying) from 0.5 to 3 h (all P < 0.001) but comparable at 4 h (P = 0.153). Similar observations were found for the model-based T1/2 and the different Tlag thresholds (all P < 0.001). Furthermore, IMD0h was found to be lower with Vital®, indicating lower gastric accommodation (faster antral filling) immediately post-ingestion (P < 0.001). Both test meals showed significant moderate-to-strong positive associations at the late-phase GE (GMR 2-4 h, T1/2) (all P < 0.05).
CONCLUSIONS: Overall, Vital® is an acceptable alternative test meal to the EWM for GES; however, exercise caution when interpreting early-phase GE. The normative values for global GES parameters and IMD0h are also established.
摘要：
目的：在胃排空闪烁显像（GES）期间测量胃排空和替代测试餐方案的适应性，比如高热量的营养饮料，没有完全建立。我们旨在比较标准蛋清餐（EWM）与高热量营养饮料（Vital®；AbbottLaboratories）在即时扫描（IMD0h）时对全球GES参数和胃内餐分布的影响。
方法：在84名接受筛查的参与者中，在这项2×2（AB/BA）交叉试验中，招募了60名无症状的健康亚洲人群（38名女性；24.0±1.5岁；23.8±2.6kg/m2）。参与者被随机分配到具有99mTc放射性标记的EWM（〜255.8kcal）的4小时GES，然后是200毫升Vital®(300千卡)，反之亦然,由2周的冲洗期分开。全球膳食滞留量(GMR)，幂指数模型排空参数(半排空[T1/2]，滞后阶段[Tlag2%，Tlag5%,Tlag10%])，和IMD0h进行测定和比较。
结果：两种测试餐的GMR均在固体GES的国际标准参考范围内。与EWM相比，Vital®在0.5至3小时内表现出明显较低的GMR（排空更快）（所有P<0.001），但在4小时时具有可比性（P=0.153）。对于基于模型的T1/2和不同的Tlag阈值，发现了类似的观察结果（所有P<0.001）。此外，在Vital®中发现IMD0h较低,提示摄入后立即降低胃适应性（胃窦充盈更快）（P<0.001）。在GE后期，两种测试餐都显示出显着的中度至重度正相关（GMR2-4h，T1/2)(均P<0.05)。
结论：总体而言，Vital®是GES可接受的EWM替代测试餐;然而,在解释早期阶段的GE时要谨慎。还建立了全局GES参数和IMD0h的标准值。
方法：在84名接受筛查的参与者中，在这项2×2（AB/BA）交叉试验中，招募了60名无症状的健康亚洲人群（38名女性；24.0±1.5岁；23.8±2.6kg/m2）。参与者被随机分配到具有99mTc放射性标记的EWM（〜255.8kcal）的4小时GES，然后是200毫升Vital®(300千卡)，反之亦然,由2周的冲洗期分开。全球膳食滞留量(GMR)，幂指数模型排空参数(半排空[T1/2]，滞后阶段[Tlag2%，Tlag5%,Tlag10%])，和IMD0h进行测定和比较。
结果：两种测试餐的GMR均在固体GES的国际标准参考范围内。与EWM相比，Vital®在0.5至3小时内表现出明显较低的GMR（排空更快）（所有P<0.001），但在4小时时具有可比性（P=0.153）。对于基于模型的T1/2和不同的Tlag阈值，发现了类似的观察结果（所有P<0.001）。此外，在Vital®中发现IMD0h较低,提示摄入后立即降低胃适应性（胃窦充盈更快）（P<0.001）。在GE后期，两种测试餐都显示出显着的中度至重度正相关（GMR2-4h，T1/2)(均P<0.05)。
结论：总体而言，Vital®是GES可接受的EWM替代测试餐;然而,在解释早期阶段的GE时要谨慎。还建立了全局GES参数和IMD0h的标准值。
