Scintigraphy in the Diagnosis of Gastrooesophageal Reflux in Children - Comparison with pH Monitoring

Overview

Gastrooesophageal reflux (GER) is defined as a retrograde flow of gastric contents across in incompetent gastrooesophageal junction into the oesophagus. Scintigraphy has an important role in the spectrum of examinations. The aim od this paper was to establish this method for children in our department and to correlate our scintigraphic findings with pH monitoring.Patients and methods: 72 children (42 boys, 30 girls) in the age of 3 months - 15 years with clinical suspicion or diagnosis of GER were examined. Scintigraphy and pH monitoring were performed in all children. The interval between both examinations was 14 - 30 days. Scintigraphy had 2 phases: 1. 30-minute dynamic scintigraphy was performed on a gamma camera HELIX (Elscint) after drinking of 99mTc Sulphur colloid in milk for infants and small children or in juice for older children. 2. Static scintigraphic images were obtained 1, 2, 4 and 24 hours following the oral administration of the radiopharmaceutical.Results: 1. 32 children had evidence of GER on scintigraphy and 40 children had negative scintigraphic findings. 2. Using pH monitoring GER was found in 36 children and no GER was detected in 36 children. 3. 13 children with negative scintigraphic findings had GER on pH monitoring. 4. 9 children with negative findings by pH monitoring exhibited GER on scintigraphy. 5. Sensitivity resp. specificity of the scintigraphy was 64% resp. 75%.Conclusion: 1. Scintigraphic findings and pH monitoring of GER agreed in 70 % of cases. 2. Scintigraphy for evaluating gastrooesophageal reflux has the advantage of being simple, sensitive and non-invasive. The quantification of scintigraphic studies is especially helpful in evaluation of severity of GER and response to therapy.

Key words:
gastrooesophageal reflux, scintigraphy using 99mTc Sulphur colloid, pH monitoring, childhood