GASTRIC-EMPTYING OF MILK FEEDINGS IN INFANTS AND CHILDREN - ANTERIOR VERSUS CONJUGATE COUNTING

The radionuclide milk scan is a valuable tool for the evaluation of ga stroesophageal reflux and gastric emptying in children. There is uncer tainty as to whether anterior imaging alone is sufficient for determin ing gastric emptying in these patients. Methods: Twenty-five children underwent Tc-99m sulfur colloid milk scans with images acquired in the anterior and posterior projections, Calculations of the 1 hour and 2 hour percentage of gastric residual activity were performed using the anterior counts alone and the geometric mean of the anterior and poste rior counts. The anterior and posterior images were visually assessed for the presence of gastroesophageal reflux. Results: The means of the absolute differences at 1 and 2 hours for the two methods of gastric residual calculation were 4.1% +/- 2.1% and 3.4% +/- 2.8%, respectivel y. There was good correlation between the two methods at 1 and 2 hours with r values of 0.991 and 0.997 respectively. Gastroesophageal reflu x was more obvious in the anterior images and three small episodes wer e only seen on the anterior view. Conclusion: Anterior images alone gi ve reliable results for the determination of gastric emptying, and gas troesophageal reflux is more readily visualized anteriorly in the pedi atric population.