EVALUATION OF ANTRAL MOTILITY IN HUMANS USING MANOMETRY AND SCINTIGRAPHY

Recent studies suggest that scintigraphy can be used to evaluate non-i nvasively antral motility in humans, although scintigraphic techniques have not yet been compared with more conventional measurements of int raluminal pressures by manometry. Simultaneous scintigraphic and manom etric measurements of antral motility were performed in nine healthy v olunteers. After intubation with a sleeve/sidehole catheter which inco rporated five pressure sideholes located at 1.5 cm intervals spanning the antrum, each subject ingested 100 g minced beef labelled with 100 MBq Tc-99m-chicken liver and 150 mi water. Between 40-43, 60-63, 80-83 , and 100-103 minutes after meal ingestion, radioisotopic data were ac quired in two second frames. Time-activity curves showing antral 'cont ractions' resulting from wall motion were derived by drawing small reg ions of interest over the antrum to coincide with the position of the antral manometric sideholes. Scintigraphic contraction rates approxima ted 3/minute, whereas antral pressure waves that occluded the lumen we re less frequent (p<0.01 for all), particularly in the proximal antrum . The amplitude of wall motion, evaluated scintigraphically, and the a mplitude of pressure waves were both inversely related to the distance from the pylorus (r>-0.32, p<0.05) and antral volume r>-0.29 (p<0.05) . There were significant relationships between the amplitude of contra ctions assessed scintigraphically and the number of lumen-occlusive an tral pressure waves in the distal antrum (r-0.48, p<0.05) but not in t he more proximal antral regions. It is concluded that scintigraphy can detect antral wall motion with greater sensitivity than manometry, pa rticularly in the proximal antrum. As manometry gives information on t he amplitude as well as the temporal and spatial organisation of those contractions which result in lumen occlusion, the combination of scin tigraphic and manometric techniques in the evaluation of antral motili ty shows considerable promise.