İNFANTLARDA VE ÇOCUKLARDA GASTROÖZEFAGİAL REFLÜ HASTALIĞININ GASTOÖZEFAGİAL REFLÜ SİNTİGRAFİSİ İLE DEĞERLENDİRİLMESİ Gastroesophageal Reflux Disease Evaluation by Gastroesophageal Reflux Scintigraphy in Infants and in Children

OZET Amac: Bolumumuze gastroozefagial reflu hastaligi suphesiyle gastroozefagial reflu sintigrafisi (GERS) icin refere edilmis infantlarda ve cocuklarda gastroozefagial reflu varliginin yani sira ilk reflu zamani, reflu episodu sayisi, reflu indeksi (RI), gastrik bosalma yuzdesi, ve gastrik bosalma yari zamanini retrospektif olarak degerlendirmeyi amacladik. Gerec-Yontemler: 2007-2019 Yillari arasinda GERS cekilmis infantlarin ve cocuklarin verileri tekrar degerlendirildi. Tum hastalarin dinamik GERS goruntuleri oncelikle vizuel olarak degerlendirildi. Sonrasinda ozefagus, mide ve gastrointestinal sistem disi alanlara cizilen belli alanlarin, alinan tum goruntuler uzerine eklenmesi ile zaman-radyoaktivite degisim grafikleri olusturuldu (Figur 1). Elde edilen veriler istatistiksel olarak degerlendirildi. Bulgular: Toplam 208 cocuk hastanin %38.5’i reflu pozitif (80/208) olarak degerlendirildi. Hastalar reflu episodu sayisina gore siniflandirildilar. Reflu sinifi ile gastrik bosalma yari zamani arasinda pozitif korelasyon (p 0.05). Sonuc: Calismamizda her iki grupta da fazla sayida reflusu olan hastalarda gastrik bosalma yari zamaninin uzadigini ve gastrik bosalma yuzdesinin de azaldigini saptadik. Ancak, gruplar arasi gastrik bosalma yari zamanlari veya gastrik bosalma yuzdeleri arasi farklilik saptanmadi. Buna bagli olarak, yas gruplardan bagimsiz olarak, GERS degerlendirmesi yapilirken vizuel degerlendirmenin yani sira gastrik bosalma yari zamaninin ve gastrik bosalma yuzdesinin kantifikasyonun taniya katkida bulunmayi saglar. Anahtar Kelimeler: Gastrozefageal Reflu Sintigrafisi; Gastroozefagial Reflu Hastaligi; Gastrik Bosalma ABSTRACT Aim: Our goal was to evaluate the gastric emptying time in either reflux positive and negative children; and also the first reflux time, the number of reflux episodes in scintigraphy, reflux index (RI), and gastric emptying half time for liquids in infants and in children who were referred to our department for gastroesophageal reflux scintigraphy (GERS) with suspicion of gastroesophageal reflux disease (GERD). Material and Methods: Dynamic GERS images were first evaluated visually and then regions of interests (ROI) were drawn on esophagus, stomach and background. Time-activity curves were generated and obtained values were statistically evaluated. Results: Among 208 patients 38.5 % of the patients were reflux positive (80/208). There was a positive correlation between degree of reflux and gastric emptying half-time (p 0.05). Conclusion: Our results show, in all groups, patients with a high number of reflux episodes have longer gastric emptying half-time with lower gastric emptying percentages. However, between groups, no significant difference was found in terms of gastric emptying percentage or gastric emptying half-time. Consequently, independently of age groups, quantitative analysis of GERS should include both the visual analysis of the reflux and also the quantification of gastric emptying half time, gastric emptying percentage which may contribute diagnosis. Keywords: Gastroesophageal Reflux Scintigraphy; Gastroesophageal Reflux Disease; Gastric Emptying