Premium
Measurement of gastric emptying of a high‐nutrient liquid by 3D ultrasonography in diabetic gastroparesis
Author(s) -
Stevens J. E.,
Gilja O. H.,
Gentilcore D.,
Hausken T.,
Horowitz M.,
Jones K. L.
Publication year - 2011
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/j.1365-2982.2010.01630.x
Subject(s) - gastroparesis , gastric emptying , scintigraphy , medicine , nuclear medicine , ultrasonography , gastroenterology , ingestion , gold standard (test) , diabetes mellitus , stomach , radiology , endocrinology
Background Gastric emptying (GE) is delayed in 30–50% of patients with longstanding diabetes. Scintigraphy represents the ‘gold standard’ for measurement of GE, but is associated with a radiation burden. Three‐dimensional (3D) ultrasonography has recently been demonstrated to provide a valid measure of liquid GE in healthy subjects; however, the technique has not been validated in patients with gastroparesis. The primary aim of this study was to compare measurements of GE of a high‐nutrient glucose drink by 3D ultrasonography and scintigraphy in diabetic gastroparesis. Methods Ten patients (eight type 1, two type 2, 6M, 4F, aged 46.1 ± 4.5 years, BMI 29.1 ± 1.6 kg m −2 , duration 19.6 ± 3.3 years) with diabetic gastroparesis [defined as retention at 100 min of solid (100 g minced beef) ≥61% and/or 50% emptying time (T50) of liquid (150 mL 10% dextrose) ≥31 min], were studied. Concurrent measurements of GE by scintigraphy and 3D ultrasonography were performed following ingestion of 75 g glucose in 300 mL water labeled with 20 MBq 99m Tc‐sulfur colloid. Key Results There was no significant difference in GE between the two techniques (T50s: scintigraphy – 103.3 ± 10.0 min VS 3D ultrasonography – 98.8 ± 10.4 min; P = 0.60). There was a significant correlation between scintigraphic and ultrasonographic T50s ( r = 0.67, P = 0.03). The limits of agreement for the T50s were −57.22 min and +48.22 min (mean difference −4.5 min). Blood glucose after the drink was greater when GE was relatively more rapid (e.g. at t = 60 min; scintigraphy: r = −0.65, P = 0.04; 3D ultrasonography: r = −0.78, P = 0.008). Conclusions & Inferences Three‐dimensional ultrasonography appears to provide a valid, and non‐invasive, measure of GE of high‐nutrient liquids in diabetic gastroparesis.