E2156. Esophageal Scintigraphy in Functional Esophageal Motility Disorders
  1. Rachana Borkar; Bridgeport Hospital
  2. Aishwariya Vegunta; Bridgeport Hospital
  3. Leonel Rodriguez; Yale New Haven Hospital
  4. Michal Kulon; Yale New Haven Hospital
Esophageal scintigraphy (ES) was first described by Kazem in 1970 to evaluate functional esophageal motility disorders. Esophageal transit time (ETT) is the time required for bolus to transit through the esophagus. Normal range of ETT is about 6 -15 seconds. Retention at 10 minutes of less than 18% is considered normal. ES also has complementary role to other modalities like contrast esophagography, esophageal manometry an esophageal endoscopy in characterizing esophageal disorders and evaluating response to therapies. ES provides precise information about transit that other studies do not, which helps in differentiating primary and secondary disorders of esophageal motility and also motor from sensory problems. It is especially important in disorders with abnormal peristalsis like achalasia and scleroderma. Findings of esophageal scintigraphy were found to be concordant in 70 - 80% of studies as compared to manometry as gold standard.

Educational Goals / Teaching Points
Review the role of esophageal scintigraphy characterizing functional esophageal motility disorders. Describe the technique and interpretation of normal and abnormal findings.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
After 4 - 6 hours of fasting, images will be acquired in upright position. 400 µCi of technician 99m sulfur colloid with milk is used for liquid meal. A second dose of 400 µCi technician 99m sulfur colloid with scrambled eggs is given for solid meal. Initially during swallowing of liquid and solid boluses, dynamic images of the chest and upper abdomen are obtained over 90 seconds. Subsequently upright static imaging are performed two minutes post swallow of liquid meal and again following solid meal ingestion.

Esophageal scintigraphy has the unique capacity to evaluate functional esophageal dysmotility. It has relatively lower radiation does as compared to contrast esophagography. It is a very well tolerated exam as it mimics real life conditions and negates the need for sedation.