142 Gastroparesis

Clinical Presentation

43-year-old insulin-dependent diabetic presenting with symptoms of post-prandial nausea, abdominal discomfort, and early satiety.

Fig. 142.1

Fig. 142.2

Technique

Standard Meal:

• 120 ml egg whites labeled with 0.5 mCi ^99mTc-sulfur colloid

• 120 ml water

• 2 slices white bread (or toast)

• 30 gm strawberry jam

Mix the sulfur colloid with the egg white and cook or microwave until done. Consume with bread, jelly and water. The meal should not take longer than 10 minutes to consume.

The patient is placed supine between the heads of a dual-headed gamma camera.

Anterior and posterior data is collected continuously for 45 minutes and divided into one-minute frames (Fig. 142.1).

Static images are obtained for one minute in anterior and posterior projections at 2 hours, 3 hours, and 4 hours after meal ingestion (as needed).

Anterior, posterior, and geometric mean time-activity curves (decay corrected) are generated from the region of interest (ROI) drawn around the stomach at each data point (Fig. 142.2).