Abstract:
Various radiologic examinations and other diagnostic tools exist for evaluating gastrointestinal diseases. When symptoms of gastrointestinal disease persist and no underlying anatomic or structural abnormality is identified, the diagnosis of functional gastrointestinal disorder is frequently applied. Given its physiologic and quantitative nature, scintigraphy often plays a central role in the diagnosis and treatment of patients with suspected functional gastrointestinal disorder. Most frequently, after functional gallbladder disease is excluded, gastric emptying scintigraphy (GES) is considered the next step in evaluating patients with suspected gastric motility disorder who present with upper gastrointestinal symptoms such as dyspepsia or bloating. GES is the standard modality for detecting delayed gastric emptying (gastroparesis) and the less commonly encountered clinical entity, gastric dumping syndrome. Additionally, GES can be used to assess abnormalities of intragastric distribution, suggesting specific disorders such as impaired fundal accommodation or antral dysfunction, as well as to evaluate gastric emptying of liquid. More recently, scintigraphic examinations for evaluating small bowel and large bowel transit have been developed and validated for routine diagnostic use. These can be performed individually or as part of a comprehensive whole-gut transit evaluation. Such scintigraphic examinations are of particular importance because clinical assessment of suspected functional gastrointestinal disorder frequently fails to accurately localize the site of disease, and those patients may have motility disorders involving multiple portions of the gastrointestinal tract. The authors comprehensively review the current practice of gastrointestinal transit scintigraphy, with diseases and best imaging practices illustrated by means of case review. ©RSNA, 2024 See the invited commentary by Maurer and Parkman in this issue.
摘要:
存在用于评估胃肠道疾病的各种放射学检查和其他诊断工具。当胃肠道疾病症状持续存在且未发现潜在的解剖或结构异常时,功能性胃肠病的诊断经常被应用。鉴于其生理和数量性质,闪烁显像在疑似功能性胃肠病患者的诊断和治疗中通常起着重要作用。大多数情况下,排除功能性胆囊疾病后,胃排空闪烁显像(GES)被认为是评估怀疑胃动力障碍并表现出消化不良或腹胀等上消化道症状的患者的下一步。GES是检测胃排空延迟(胃轻瘫)的标准模式,也是较不常见的临床实体。胃倾倒综合征.此外,GES可用于评估胃内分布异常,提示特定的疾病,如受损的眼底调节或胃窦功能障碍,以及评价胃液体的排空。最近,已经开发并验证了用于评估小肠和大肠转运的闪烁显像检查,以用于常规诊断。这些可以单独进行或作为全面的全肠运输评估的一部分进行。这种闪烁显像检查特别重要,因为对疑似功能性胃肠病的临床评估经常无法准确定位疾病部位。这些患者可能患有涉及胃肠道多个部分的运动障碍。作者全面回顾了胃肠运输闪烁显像的当前实践,通过病例审查说明疾病和最佳成像实践。©RSNA,2024请参见本期Maurer和Parkman的特邀评论。