ESOPHAGEAL SCINTIGRAPHY OF ZENKERS DIVERT ICULA BEFORE AND AFTER DIVERTICULOTOMY

Aim: The filling and evacuation of Zenker's diverticula were scintigra phically examined before and after operation to quantify their functio nal relevance. These results were correlated with the symptoms of the patients and the findings of the barium swallow x-ray examination usin g cineradiography, Methods: Sequential and static esophageal scintigra phies were performed in 17 patients with Zenker's diverticulum before and after laser surgical diverticulotomy. We used a gamma camera syste m in 45 degrees LAG-position after application of 15 mi of tea which w as marked with Tc-99m-DTPA. Filling and evacuation of the diverticulum were expressed in proportion to the administered activity. Relative v olumes of the diverticula were obtained from cineradiography by using the height of the neighbouring cervical vertebra, and the clinical sym ptoms were divided into 4 groups. Results: Zenker's diverticula could be verified visually and quantitatively by scintigraphy. The precise t emporal course of the reduction of activity in the diverticulum was ex actly determined. The scintigraphic retentions correlated with the x-r ay volumes with a coefficient ranging from 0,55 to 0,85. Clinical symp toms also were not very closely related to scintigraphic and x-ray fin dings, respectively. Conclusion: The esophageal scintigraphy allows qu antification of the filling and evacuation of Zenker's diverticula, th us it is suitable for objectivization of the functional relevance of t he diverticula. That's why the esophageal scintigraphy should be taken to the diagnosis of diverticula in addition to the clinic and the x-r ay examinations. The method is especially useful to evaluate the resul ts after diverticulotomy.