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Gastric emptying and small intestinal transit time in preterm infants: a scintigraphic method
Susan Bodé1, Marianne Dreyer, Gorm Greisen
1Neonatal Department, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark. rh02108@rh.dk
Insights
This study developed a safe and practical scintigraphic method to measure gastric emptying and small intestinal transit time in preterm infants, offering a valuable research tool.
Area of Science:
- Neonatal physiology
- Gastroenterology
- Medical imaging
Background:
- Accurate assessment of gastric emptying (GE) and small intestinal transit time is crucial for preterm infants.
- Existing methods may involve significant radiation exposure or physical disturbance.
- There is a need for practical, low-radiation techniques for these vulnerable infants.
Purpose of the Study:
- To develop and validate a scintigraphic method for determining GE and small intestinal transit time in preterm infants.
- To minimize radiation exposure and physical disturbance during the assessment.
- To establish a safe and practicable research tool for neonatal studies.
Main Methods:
- A low-dose (0.2-0.4 MBq) 99mTc-DTPA tracer was administered orally to ten preterm infants.
- Static scintigraphic images were acquired over 9-12 hours using a mobile gamma camera.
- Regions of interest (ROIs) in the stomach and cecum allowed calculation of GE half-time and orocecal transit time.
Main Results:
- Gastric emptying was successfully visualized in all infants.
- Median gastric emptying half-time was 1.0 hour.
- Median orocecal transit time in nine infants was 3.1 hours; one infant did not reach the cecum within 12 hours.
Conclusions:
- A novel scintigraphic method for assessing GE and orocecal transit time in preterm infants has been developed.
- The method is demonstrated to be safe and practicable for research purposes.
- This technique offers a valuable, low-radiation option for studying gastrointestinal function in neonates.
Objectives:
Practical methods to determine gastric emptying (GE) and small intestinal transit time in preterm infants are required. The aim of this study was to develop a scintigraphic method to determine GE and small intestinal transit time in preterm infants which produce minimal radiation exposure and physical disturbance in these infants.
Methods:
Ten premature infants were studied. Median (and range) for gestational age was 28.9 (26-33) weeks, postnatal age was 19 (6-37) days, birth weight was 1194 (687-2300) grams and feeding volume was 173 (6-205) mL/kg/day. Nine of the patients were on nasal continuous positive airway pressure; one patient was on mechanical ventilation. A dose (0.2-0.4 MBq) of 99mTc-DTPA (0.5 mL) was given at the end of a meal administered by naso-gastric tube. Static images were obtained with a mobile gamma camera during the next 9 to 12 hours. The radiation dose was at most 0.30 mSv. Regions of interest (ROIs) were drawn around the stomach and the cecum. Time-activity curves were generated. Gastric emptying half-time (T(1/2)GE) was calculated. Residual gastric activity after 1 hour (R(1h)) and after 2 hours (R(2h)) was determined. Orocecal transit time was defined as the time until significant increase in activity was detected in the cecal ROI.
Results:
Images showed gastric emptying in all cases. Median (range) half time was 1.0 (0.5-3.0) h. R(1h) was 37.5% (19% to 100%), R(2h) was 23% (6% to 61%). In one patient the tracer did not reach the cecum within 12 hours. In the remaining nine patients orocecal transit time was 3.1 (1.3-6.1) h.
Conclusions:
We present a new scintigraphic method to determine GE and orocecal transit time. It appears safe and practicable as a research tool in preterm infants.
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