Challenges in the Diagnosis of Gastroparesis: Divergence Between Gastric Emptying Scintigraphy Results for Liquids and Solids
DOI:
https://doi.org/10.22516/25007440.1228Keywords:
Gastroparesis, gastric emptying, Scintigraphy, FoodAbstract
Introduction: Gastric emptying scintigraphy with solid food is the recommended gold standard for studying gastroparesis in patients after mechanical obstruction has been ruled out, according to the latest clinical guidelines. Although gastric emptying for liquids can also be assessed, the results of these two phases may not always align.
Objective: To determine the level of concordance between gastric emptying scintigraphy results for solids and liquids in the evaluation of gastroparesis at three nuclear medicine centers in Bogotá, Colombia.
Methodology: Data from all patients who underwent both phases of the study were reviewed. Patients under 18 years of age, those with accelerated results in either phase, or those with incomplete data were excluded. Cohen’s kappa coefficient was calculated to assess agreement between the tests. A bivariate analysis was performed to examine the association between test results, the level of agreement, and sociodemographic and clinical variables.
Results: A total of 210 patients met the inclusion criteria. Delayed results were observed in the solid phase in 86 patients (41%) and in the liquid phase in 181 patients (86%). The kappa value was κ = 0.082 (95% confidence interval [CI]: 0.005–0.16), with statistically significant results (p < 0.05). The most common pattern of divergence was normal solid-phase emptying with delayed liquid-phase emptying, observed in 102 patients (48.6%).
Conclusion: The level of concordance between gastric emptying scintigraphy for liquids and solids is low. The solid phase is considered the gold standard, and the results of the liquid phase should be interpreted with caution, taking into account the clinical context of each patient.
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