Biphasic solid and liquid gastric emptying in normal controls and diabetics using continuous acquisition in LAO view

The purpose of this study was to investigate the various phases of gastric emptying using a dual-isotope liquid-solid meal ([99mTc]SC egg sandwich and [111In]DPTA in water) and continuous acquisition in the left anterior oblique view. The study groups consisted of 10 normal controls and 20 diabetics with symptoms suggestive of diabetic gastroparesis. Solid-phase emptying in both groups almost always had a lag phase followed by linear emptying. Liquid-phase emptying was biexponential in 4/10 normals and 12/20 diabetics, with a short early rapid emptying rate (mean T1/2 = 48 min in normals and 79 min in diabetics). Solid emptying was delayed in 10, normal in eight, and rapid in two diabetics. Liquid emptying was delayed in 9/10 diabetics who had delayed solid emptying. Diabetics as a group had a significantly delayed solid lag phase (P less than 0.025), rate of emptying (P less than 0.05) and percent emptying at 90 min (P less than 0.025) compared to normal controls. Diabetic liquid emptying was also significantly delayed (P less than 0.025). The second component of liquid emptying strongly correlated with the solid rate of emptying (r = 0.826 in normals and 0.855 in diabetics). Continuous acquisition of gastric emptying studies in the LAO view has allowed us to better define the various phases of solid and liquid gastric emptying.