^(99m)Tc-EHIDA闪烁显像研究胆汁反流性胃炎胆汁排泌途径异常

Study of dynamic multi-temporal ^(99m)Tc-EHIDA scintigraphy in bile reflux gastritis biliary at abnormal excretion pathway

目的探讨动态多时相99m Tc-EHIDA显像技术分析生理状态下胆汁反流性胃炎的胆汁排泌功能途径的变化。方法正常对照组12例,其中男性7例,女性5例;年龄38~68岁,平均年龄53.2岁。胆囊结石组12例,其中男性6例,女性6例;年龄33~67岁,平均年龄51.7岁。胆汁反流性胃炎组23例,其中男性14例,女性9例;年龄23~56岁,平均年龄42.0岁。应用动态多时相99m Tc-EHIDA闪烁显像技术,分析胆汁排泌途经。结果胆汁反流性胃炎组排胆分数(GBEF)、排胆率(GBER)与正常对照组差异无统计学意义,但高于胆囊结石组。胆汁反流性胃炎组中,与6例反流阴性和13例轻度反流患者相比,4例呈重度反流患者显像剂在肠道的放射性浓集程度明显减低,且十二指肠开始显影的时间均在35 min后。结论动态多时相99m Tc-EHIDA闪烁显像能生理(非侵入)状态下检测胆汁排泌的途径异常,其临床诊断价值肯定。

Objective To explore the change of physiological condition（non-invasive） in bile gastritis biliary at abnormal excretion pathway by dynamic multi-temporal99mTc-EHIDA scintigraphy imaging technology. Methods A total of 45 cases were enrolled, which were divided into 3 groups： normal control group（n = 12, included 7 males and 5 females, aged 38- 68 years old with mean age of 53.2 years old）, gallstone group（n = 12, included 6 males and 6 females, aged 33- 67 years old with mean age of51.7 years old） and bile reflux gastritis group（n = 23, included 14 males and 9 females, aged 23- 56 years old with mean age of42.0 years old）. The excretion pathway were analyzed by multi-temporal99mTc-EHIDA dynamic scintigraphy technology. Results The gallbladder ejection fraction（GBEF） and gallbladder excretion rate（GBER） were no significant differences between bile reflux gastritis group and normal control group, but higher than in gallstone group. Compared with 6 cases of reflux negative patients and13 cases of mild regurgitation lighter patients, the intestinal radioactive concentration degree of imaging agent in 4 cases of severe reflux patients were decreased obviously, and duodenal image was appeared after 35-minute. Conclusion It is demonstrated that dynamic multi-temporal99mTc-EHIDA scintigraphy imaging technology could detect physiological condition（non-invasive） in bile gastritis biliary at abnormal excretion pathway, and the clinical diagnosis value could significantly improve and optimize reflux gastritis.