Journal of Mazandaran University of Medical Sciences (Jan 2007)
The relationship between dyspepsia and increased radiotracer uptake in the gastric wall during 99mTc-MIBImyocardial perfusion imaging
Abstract
AbstractBackground and purpose: There are evidences indicating increased 99mTc-MIBI uptake by the gastric wall in myocardial perfusion SPECT connected with dyspepsia symptoms. In this study we aimed at investigating the frequency and structure of dyspeptic symptoms in patients showing gastric wall hyperactivity in 99mTc-MIBI myocardial perfusion SPECT and to determine any association between the existing symptoms and this scintigraphic finding.Materials and Methods: 1120 consecutive outpatients referred for myocardial perfusion SPECT were interviewed about the dyspeptic symptoms, current gastric medications and previous gastroduodenal interventions. The intensity of gastric wall activity was graded qualitatively as A or hyperactive gastric wall (equivalent to the heart activity) and B (less than heart activity).Results: Increased gastric wall uptake was seen in 1.78% of the patients. Dyspeptic symptoms were present in 80% and 19.3% of A and B patients, respectively (P<0.001). The dyspeptic symptoms were classified as ulcer-like in 37.5%, dysmotility-like in 43.75% and GERD-like in 18.75% of the dyspeptic A patients. Considering the classification of dyspepsia, there was no significant difference between the different groups. All of the eight different symptoms of dyspepsia had significantly higher prevalence in group A (all P values were less than 0.001). The history of previous upper GI endoscopy past history of previous gastroduodenal surgery and frequency of current use of gastric medications were significantly higher in group A.Conclusion: Although the clinical role of gastric wall hyperactivity detection is not yet clearly defined, report of this infrequent accidental finding should be part of the report of radionuclide imaging of the heart and may identify a category of patients, who require additional diagnostic gastrointestinal investigation to specify other possible noncardiac origins of their pain (and even the only origin of patients symptoms).
