CN110743021A - Liquid test meal for gastroesophageal reflux and imaging method thereof - Google Patents

Liquid test meal for gastroesophageal reflux and imaging method thereof Download PDF

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Publication number
CN110743021A
CN110743021A CN201911203611.5A CN201911203611A CN110743021A CN 110743021 A CN110743021 A CN 110743021A CN 201911203611 A CN201911203611 A CN 201911203611A CN 110743021 A CN110743021 A CN 110743021A
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mixture
subject
gastroesophageal reflux
liquid
meal
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王雪梅
王相成
何玉林
郝喜燕
周伟娜
白侠
赵振峰
牛瑞龙
王涛
邬心爱
王城
王春梅
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K49/00—Preparations for testing in vivo
    • A61K49/0004—Screening or testing of compounds for diagnosis of disorders, assessment of conditions, e.g. renal clearance, gastric emptying, testing for diabetes, allergy, rheuma, pancreas functions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K51/00—Preparations containing radioactive substances for use in therapy or testing in vivo
    • A61K51/02—Preparations containing radioactive substances for use in therapy or testing in vivo characterised by the carrier, i.e. characterised by the agent or material covalently linked or complexing the radioactive nucleus
    • A61K51/025—Preparations containing radioactive substances for use in therapy or testing in vivo characterised by the carrier, i.e. characterised by the agent or material covalently linked or complexing the radioactive nucleus inorganic Tc complexes or compounds

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  • Endocrinology (AREA)
  • Gastroenterology & Hepatology (AREA)
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Abstract

The invention relates to a liquid test meal for gastroesophageal reflux and a developing method thereof, wherein the test meal is divided into a mixture A of radioactive reagent and 100ml of pure milk and a mixture B of 400ml of pure milk and pure water, so that the test meal does not contain an acidic solvent completely, avoids injuries such as mistaken taking and the like, and forms an evaluation effect under a complete physiological state; in addition, the invention can adjust the dosage of the purified water according to the individual difference of the testee, so that the test meal of the invention can avoid the influence of the insufficient liquid quantity on the satiety of the testee, and can simultaneously avoid the vomiting phenomenon caused by the excessive liquid quantity in the test meal, thereby influencing the test result and the state of the testee. In the imaging method, dynamic acquisition of 20 s/frame is firstly carried out, the radioactivity distribution change in the esophagus and the stomach region is observed, then fusion fault acquisition is carried out, and the physiological state is completely simulated by adopting a mode of no pressurization on the abdomen in the acquisition process, so that a more accurate gastroesophageal reflux-flow index is obtained.

Description

Liquid test meal for gastroesophageal reflux and imaging method thereof
Technical Field
The invention belongs to the field of nuclear medicine, and particularly relates to a gastroesophageal reflux liquid test meal and an imaging method thereof.
Background
The method for judging whether gastric contents reflux to the esophagus or not is achieved by acquiring the calculation of the amount of nuclides in the esophagus and the stomach in a certain time through SPECT (single photon emission computed tomography) at different time when the nuclide-marked test meal passes through the esophagus, the stomach and the duodenum after oral administration. In the diagnosis method of gastroesophageal reflux disease, compared with upper gastrointestinal endoscopy, 24h esophagus pH monitoring, esophagus manometry and the like, the method has the advantages of being more physiological and non-invasive. Because the preparation is carried out under physiological conditions and has non-traumatic characteristics, all diners can check the preparation without obvious complications and adverse reactions, thereby having unique clinical value. Commonly used methods include: commonly used imaging agents are99mTc-sulphur colloid or99mAcidic imaging agent prepared from Tc-DTPA (150ml of orange juice, 150ml of 0.1mol/L HCL, 14.8-37 MBq)(0.4-1mci) SC or DTPA), adding the above developer into milk at a ratio of 300ml/1.7m for infant examination2Activity 7.4-11.1MBq (200-. mu. Ci)); fasting the subject for 4-12 h; the preparation method and the dosage of the developer are strictly in accordance with the requirements of the method; before imaging, observing whether residual radioactivity exists at the esophagus part on a view screen, if so, observing after drinking a plurality of mouths of water, and if not, carrying out serial imaging; the pressure during abdominal pressurization needs to be accurate, otherwise the result accuracy is affected; when the ROI of the esophagus part is drawn, the contour of the stomach of each frame needs to be consistent as much as possible.
Thus, in order to perform the examination under the complete physiological condition, it is necessary to develop a new and more practical liquid test and imaging method for gastroesophageal reflux.
Disclosure of Invention
In view of the above, it is an object of the present invention to provide a liquid meal for gastroesophageal reflux; it is another object of the present invention to provide a novel developing method.
In order to achieve the purpose, the invention provides the following technical scheme:
1. a liquid meal for gastroesophageal reflux, the liquid meal comprising a mixture A and a mixture B, the mixture A consisting of a radioactive agent and 100ml of pure milk; the mixture B consists of 400ml of pure milk and purified water.
Preferably, the radioactive agent is 99mTc-SC, and the content of the radioactive agent is 14.8-37 MBQ.
Preferably, the amount of purified water in the mixture B is determined according to the requirement of the subject for satiety, and the temperature of the purified water is 25-45 ℃.
Preferably, the mixture A is taken in its entirety within 3min, and the mixture B is taken after the subject takes the mixture A.
2. A method for developing by adopting the liquid test meal specifically comprises the following steps:
(1) the subject took a liquid test meal: allowing the subject to take mixture A for 3min and then allowing the subject to continue taking mixture B until the subject feels satiety;
(2) immediately placing a subject taking the liquid meal under a SPECT/CT probe in a supine position, taking an anterior position for imaging, and enabling the esophagus and the stomach of the subject to appear in a visual field;
(3) static continuous scanning: firstly, static scanning and continuous acquisition are carried out at the speed of 20 s/frame, and then fusion fault acquisition is carried out;
(4) and (4) obtaining the gastroesophageal reflux index according to the result collected in the step (3).
Preferably, the static scan is stopped when a positive reflux sign is detected in the static scan.
Preferably, the parameters during continuous acquisition are set as follows: the probe is provided with a low-energy universal or high-sensitivity collimator, the energy peak is 140keV, the window width is 20 percent, the matrix is 64 multiplied by 64, ZOOM: 1.0.
preferably, the parameters during the acquisition of the fusion fault are set as follows: energy peak 140keV, window width 20%, matrix 128 x 128, 9 seconds/frame, for a total of 32 frames.
The invention has the beneficial effects that:
1. the invention provides a liquid test meal for gastroesophageal reflux, which is divided into a part of a mixture A consisting of radioactive reagent and 100ml of pure milk and a part of a mixture B consisting of 400ml of pure milk and purified water, and the two parts are taken in sequence, so that the test meal does not contain an acidic solvent completely, avoids injuries such as mistaken taking and the like, and forms an evaluation effect in a complete physiological state; in addition, the invention can adjust the dosage of the purified water according to the individual difference of the testee, so that the test meal of the invention can avoid the influence of the insufficient liquid quantity on the satiety of the testee, and can simultaneously avoid the vomiting phenomenon caused by the excessive liquid quantity in the test meal, thereby influencing the test result and the state of the testee.
2. The invention also provides a method for developing by adopting the liquid test meal, which comprises the steps of firstly carrying out dynamic acquisition of 20 s/frame, observing the radioactivity distribution change in the esophagus and the stomach region, continuously acquiring for 30min or immediately carrying out fault acquisition when a reflux symptom appears, and then carrying out fusion fault acquisition, wherein the physiological state is completely simulated by adopting an abdominal non-pressurization mode in the acquisition process, so that a more accurate gastroesophageal reflux-reflux index is obtained.
Additional advantages, objects, and features of the invention will be set forth in part in the description which follows and in part will become apparent to those having ordinary skill in the art upon examination of the following or may be learned from practice of the invention. The objectives and other advantages of the invention may be realized and attained by the means of the instrumentalities and combinations particularly pointed out hereinafter.
Drawings
For the purposes of promoting a better understanding of the objects, aspects and advantages of the invention, reference will now be made to the following detailed description taken in conjunction with the accompanying drawings in which:
FIG. 1 is an esophageal-time radioactivity curve and a fusion tomographic image of a subject in example 1, wherein a is the esophageal-time radioactivity curve and b is the fusion tomographic image;
FIG. 2 is an esophageal-time radioactivity curve and a fusion tomographic image of a subject three months after endoscopic surgery in example 2, wherein a is the esophageal-time radioactivity curve and b is the fusion tomographic image.
Detailed Description
The embodiments of the present invention are described below with reference to specific embodiments, and other advantages and effects of the present invention will be easily understood by those skilled in the art from the disclosure of the present specification. The invention is capable of other and different embodiments and of being practiced or of being carried out in various ways, and its several details are capable of modification in various respects, all without departing from the spirit and scope of the present invention.
Example 1
A developing method comprises the following steps:
(1) subjects (male, 56 years old, hiatal hernia for 3 years) took liquid meals: completely taking a mixture A consisting of a radioactive reagent 99mTc-SC and 100ml of pure milk by a subject within 3min, and then continuously taking a mixture B consisting of 400ml of pure milk and purified water with the temperature of 25-45 ℃ (taking 400ml of pure milk first and then taking purified water) by the subject until the subject feels satiety;
(2) after the liquid meal is taken by the testee, the testee immediately lies on the back under the SPECT/CT probe, and the front position is taken for imaging, so that the esophagus and the stomach of the testee appear in the visual field;
(3) static continuous scanning: firstly, performing static scanning (the static scanning can be stopped when a positive reflux symptom appears in the static scanning) and continuous acquisition (the parameters during the continuous acquisition are set as that a probe is configured with a low-energy universal or high-sensitivity collimator, the energy peak is 140keV, the window width is 20%, the matrix is 64 x 64, and the ZOOM is 1.0), then performing fusion fault acquisition (the parameters during the fusion fault acquisition are set as that the energy peak is 140keV, the window width is 20%, the matrix is 128 x 128, 9 seconds per frame and totally 32 frames), when 11 frames are acquired, increasing the upper stomach strip metabolism shadow and continuously increasing the radioactivity along with the time to obtain an esophagus-time radioactivity curve and a fusion fault image, as shown in figure 1 (wherein a is the esophagus-time radioactivity curve, and b is the fusion fault image), and the reflux index is 5.92%;
(4) and calculating the gastroesophageal reflux index to be 5.92 percent according to the esophagus-time radioactivity curve obtained by scanning and the fusion tomography image, and according with the gastroesophageal reflux performance.
Example 2
The subjects in example 1 were subjected to endoscopy, and after three months, they were subjected to gastroesophageal reflux imaging using the imaging method in example 1, and the resulting esophageal-time radioactivity curve and fusion tomographic image were as shown in fig. 2 (wherein a is an esophageal-time radioactivity curve, and b is a fusion tomographic image), and further, their reflux index was 2.52%.
Through the gastroesophageal reflux imaging result and the obtained reflux index in the embodiment, the liquid meal test and imaging method for gastroesophageal reflux provided by the invention can obtain a more accurate gastroesophageal reflux-index, and the reason is that: the invention provides a liquid test meal for gastroesophageal reflux, which is divided into a part of a mixture A consisting of radioactive reagent and 100ml of pure milk and a part of a mixture B consisting of 400ml of pure milk and purified water, and the two parts are taken in sequence, so that the test meal does not contain an acidic solvent completely, avoids injuries such as mistaken taking and the like, and forms an evaluation effect in a complete physiological state; in addition, the dosage of the purified water required by the invention can be adjusted according to the individual difference of the subject, so that the test meal of the invention can avoid the influence of insufficient liquid quantity on the satiety of the subject, and can avoid the vomiting phenomenon caused by excessive liquid quantity in the test meal, thereby influencing the test result and the state of the subject; in addition, the invention also provides a method for developing by adopting the liquid test meal, which comprises the steps of firstly carrying out dynamic acquisition of 20 s/frame, observing the radioactivity distribution change in the esophagus and the stomach region, continuously acquiring for 30min or immediately carrying out fault acquisition when a reflux symptom appears, and then carrying out fusion fault acquisition, wherein the physiological state is completely simulated by adopting an abdominal unpressurized mode in the acquisition process, so that a more accurate gastroesophageal reflux-flow index is obtained.
Finally, the above embodiments are only intended to illustrate the technical solutions of the present invention and not to limit the present invention, and although the present invention has been described in detail with reference to the preferred embodiments, it will be understood by those skilled in the art that modifications or equivalent substitutions may be made on the technical solutions of the present invention without departing from the spirit and scope of the technical solutions, and all of them should be covered by the claims of the present invention.

Claims (8)

1. A liquid meal for gastroesophageal reflux, wherein the liquid meal comprises a mixture A and a mixture B, the mixture A is composed of a radioactive agent and 100ml of pure milk; the mixture B consists of 400ml of pure milk and purified water.
2. The liquid trial of gastroesophageal reflux according to claim 1, wherein the radioactive agent is 99mTc-SC and the content of the radioactive agent is 14.8 to 37 MBQ.
3. The liquid test meal for gastroesophageal reflux according to claim 1, wherein the amount of purified water in the mixture B is determined according to the need of the subject to develop satiety, and the temperature of the purified water is 25-45 ℃.
4. The liquid meal for gastroesophageal reflux according to any one of claims 1 to 3, wherein the mixture A is taken in its entirety within 3min and the mixture B is taken by the subject after the mixture A is taken.
5. A method for imaging using a liquid meal of any of claims 1 to 4, the method comprising:
(1) the subject took a liquid test meal: allowing the subject to take mixture A for 3min and then allowing the subject to continue taking mixture B until the subject feels satiety;
(2) immediately placing a subject taking the liquid meal under a SPECT/CT probe in a supine position, taking an anterior position for imaging, and enabling the esophagus and the stomach of the subject to appear in a visual field;
(3) static continuous scanning: firstly, static scanning and continuous acquisition are carried out at the speed of 20 s/frame, and then fusion fault acquisition is carried out;
(4) and (4) obtaining the gastroesophageal reflux index according to the result collected in the step (3).
6. The method of claim 5, wherein the static scan is stopped when a positive reflux sign is detected in the static scan.
7. The method of claim 5, wherein the parameters of the continuous acquisition are set as follows: the probe is provided with a low-energy universal or high-sensitivity collimator, the energy peak is 140keV, the window width is 20 percent, the matrix is 64 multiplied by 64, ZOOM: 1.0.
8. the method of claim 5, wherein the parameters of the fusion fault acquisition are set as follows: energy peak 140keV, window width 20%, matrix 128 x 128, 9 seconds/frame, for a total of 32 frames.
CN201911203611.5A 2019-11-29 2019-11-29 Liquid test meal for gastroesophageal reflux and imaging method thereof Pending CN110743021A (en)

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101420985A (en) * 2006-04-13 2009-04-29 大塚制药株式会社 Test agent for diagnosing dyspepsia
US20090269758A1 (en) * 2007-03-29 2009-10-29 Boles Richard G Diagnostic methods and kits for functional disorders

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101420985A (en) * 2006-04-13 2009-04-29 大塚制药株式会社 Test agent for diagnosing dyspepsia
US20090269758A1 (en) * 2007-03-29 2009-10-29 Boles Richard G Diagnostic methods and kits for functional disorders

Non-Patent Citations (3)

* Cited by examiner, † Cited by third party
Title
K. PITTSCHIELER: "Dumping syndrome after combined pyloroplasty and fundoplication", 《EUR J PEDIATR》 *
YODPHAT KRAUSZ ET AL: "Scintigraphic evaluation of esophageal transit and gastric emptying in familial dysautonomia", 《EUROPEAN JOURNAL OF RADIOLOGY》 *
雷蕾: "护理干预在儿童患者ECT检查中的应用", 《泸州医学院学报》 *

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Application publication date: 20200204