Sensitivity of Esophageal Scintigraphy (Milk Scans) in Detecting Gastro-Esophageal Reflux

Awad  Alzahrani; Saeed  Bafaraj

doi:10.4236/ojmi.2015.51001

Saeed Bafaraj, Awad Alzahrani

Abstract: Gastro-esophageal scintigraphy (milk scan) is an accurate technique for detecting gastro-esophageal reflux that can be performed rapidly with minimal patient discomfort. A retrospective study was performed to find out to how much radionuclide milk scan is sensitive for detecting gastro-esophageal reflux (GER) for 89 patients who subjected to milk scan within Years 2010 to 2013. The study group age is ranging from one month old to four years old. Milk scan was performed using PHILIPS and SEIMENS machine. Tc 99-m sulfur colloid with milk administrated orally or through nasogastric tube to the patient. The highest frequency for milk scan study was in age group of 0 - 6 months old with 77% positive finding. Patients who suffer repeated vomiting represented the highest reason of examination for milk scan (46% of overall cases), while chocking attacks, pulmonary aspiration, and congenital heart disease, were 26%, 16%, 12% respectively of the overall cases. Seventy-nine percent of patients who prepared to be examine using nasogastric tube found with positive finding, 50% of GER patients have abnormal tracer activity in the mid of esophagus; on the other hand, 50% of GER patients divided equally between the lower and upper esophagus. The study show that infants especially in age of 0 - 6 months old and with repeated vomiting symptoms are strongly recommended to milk scan study rather than fluoroscopy to avoid unnecessary dose to the patients.

Keywords: Gastro-Esophageal Scintigraphy, Milk Scan, Gastro-Esophageal Reflux

Cite this paper: Bafaraj, S. and Alzahrani, A. (2015) Sensitivity of Esophageal Scintigraphy (Milk Scans) in Detecting Gastro-Esophageal Reflux. Open Journal of Medical Imaging, 5, 1-9. doi: 10.4236/ojmi.2015.51001.

References

[1] Thrall, J.H. and Ziessman, H.A. (2001) Nuclear Medicine: The Requisites. 2nd Edition, Mosby, St. Louis, 233-237.

[2] Blumhagen, J.D., Rudd, T.G. and Christie, D.L. (1980) Gastroesophageal Reflux in Children: Radionuclide Gastroesophagography. American Journal of Roentgenology, 135, 1001-1004.
http://dx.doi.org/10.2214/ajr.135.5.1001

[3] Piepsz, A., Georges, B., Rodesch, P. and Cadranel, S. (1982) Gastroesophageal scintiscanning in children. Journal of Nuclear Medicine, 23, 631-632.

[4] Arasu, T.S., Wyllie, R., Fitzgerald, J.F., Franken, E.A., Siddiqui, A.R., Lehman, G.A., et al. (1980) Gastroesophageal Reflux in Infants and Children Comparative Accuracy of Diagnostic Methods. The Journal of Pediatrics, 96, 798-803.
http://dx.doi.org/10.1016/S0022-3476(80)80545-2

[5] Seibert, J.J., Byrne, W.J., Euler, A.R., Latture, T., Leach, M. and Campbell, M. (1983) Gastroesophageal Reflux—the Acid Test: Scintigraphy or the pH Probe? American Journal of Roentgenology, 140, 1087-1090.
http://dx.doi.org/10.2214/ajr.140.6.1087

[6] Patwari, A.K., Bajaj, P., Kashyp, R, Anand, V.K., Gangil, A., Jain, A., et al. (2002) Diagnostic Modalities for Gastroesophageal Reflux. The Indian Journal of Pediatrics, 69, 133-136.
http://dx.doi.org/10.1007/BF02859372

[7] Tolia, V., Kuhns, L. and Kauffman, R.E. (1993) Comparison of Simultaneous Esophageal pH Monitoring and Scintigraphy in Infants with Gastroesophageal Reflux. The American Journal of Gastroenterology, 88, 661-664.

[8] Nelson, S.P., Chen, E.H., Syniar, G.M. and Christoffel, K.K. (1997) Prevalence of Symptoms of Gastroesophageal Reflux during Infancy: A Pediatric Practice Based Survey. Archives of Pediatrics and Adolescent Medicine, 151, 569- 572.
http://dx.doi.org/10.1001/archpedi.1997.02170430035007