RT Journal Article
SR Electronic
T1 Classification Schema of Symptomatic Enterogastric Reflux Utilizing Sincalide Augmentation on Hepatobiliary Scintigraphy
JF Journal of Nuclear Medicine Technology
JO J. Nucl. Med. Technol.
FD Society of Nuclear Medicine
SP 198
OP 202
DO 10.2967/jnmt.114.141168
VO 42
IS 3
A1 Matthew F. Covington
A1 Elizabeth Krupinski
A1 Ryan J. Avery
A1 Phillip H. Kuo
YR 2014
UL http://tech.snmjournals.org/content/42/3/198.abstract
AB Enterogastric reflux (EGR) is the reflux of duodenal contents into the stomach. Hepatobiliary scintigraphy provides physiologic assessment of the biliary system and was used to test the hypothesis that presence and timing of EGR may be associated with infusion of sincalide, a surrogate of endogenous cholecystokinin. Methods: One hundred fifty-seven hepatobiliary scintigraphy studies were retrospectively reviewed. Data included EGR incidence on initial reports, incidence after masked second reads, and time of EGR onset in relation to sincalide infusion. EGR cases were then classified according to onset on pre-, post-, or both presincalide and postsincalide imaging. Results: Time of EGR onset at 19–24 minutes after start of a 15-min sincalide infusion differed significantly from normal (p<0.0001). EGR was initially reported in 14 of 157 cases (8.9%) but found in 38 of 157 cases on masked second reads (24.2%), corresponding to a 15.3% discrepancy rate. Conclusion: The temporal association of EGR onset with sincalide infusion may identify patients with EGR mimicking chronic cholecystitis or biliary dyskinesia. A novel classification schema was therefore developed as a framework for future research, utilizing EGR onset in relation to pre-, post-, or both presincalide and postsincalide imaging as a hypothetical biomarker of clinically significant EGR.