SIMPLIFIED METHOD FOR THE MEASUREMENT OF SEGMENTAL COLONIC TRANSIT-TIME

Segmental colonic transit has been measured in 101 patients. Two MBq o f (111)Indium absorbed on resin pellets and encapsulated in an enteric coated capsule was given at 7 00 am. Hourly images during the first d ay, and three images during each subsequent day were acquired for up t o three days. Using all scan and patient data the scans were categoris ed in one of the five patterns of colonic transit: normal, rapid, righ t delay, left delay, or generalised delay. The geometric centres and p er cent activity at each time point was compared between the five grou ps of colonic transit patients to find the best time for imaging and s o to distinguish the five groups. During the first day, early images d id not help in diagnosis of patterns of transit, however, in the later images (six hours onwards after the ingestion of the activity) the ra pid transit groups could be identified. Images at 27 and 51 hours were both required to distinguish all five groups of patients from each ot her. Only in the 'normal' transit patients was there some excretion of the activity during the course of the second day, otherwise there was no difference in the images taken in the course of a day (second or t hird day). A simplified protocol requires a minimum of three images to distinguish all five patterns of colonic transit. The activity should be ingested in the morning (7 00 am) and the first image taken at the end of the working day (8-10 hours after ingestion), the second image on the morning of the second day, and the third image during the cour se of the third day. This simple protocol would provide all the clinic ally relevant information necessary for correct classification of the colonic transit.