Detection of Symptomatic Heterotopic Gastric Mucosa of the Upper Esophagus using Tc-99m Pertechnetate Scintigraphy

Abstract

"Detection of Symptomatic Heterotopic Gastric Mucosa of the Upper Esophagus using Tc-99m Pertechnetate Scintigraphy Heterotopic gastric mucosa of the upper esophagus (HGMUE) often referred to as an inlet patch, is an asymptomatic benign lesion. However, this inlet patch may cause esophageal ulceration and stricture, leading to symptoms such as pharyngeal discomfort, retrosternal chest pain and dysphagia. It is probable that the inlet patch is more frequent in patients with pharyngeal symptoms than in asymptomatic patients. This study was to evaluate feasibility and usefulness of Tc-99m pertechnetate (99mTcO4-) esophageal scan in differentiating symptomatic and asymptomatic HGMUEs. MATERIALS AND METHODS: 15 patients (9 male and 6 female) diagnosed as HGMUE were enrolled and carefully questioned, especially with regard to pharyngeal and esophageal complaints and these symptoms were scored. Esophageal scan was performed after intravenous administration of 370MBq of Tc-99m pertechnetate and serial static images and single-photon emission computed tomography (SPECT) data were obtained. Lugol solution was used to suppress thyroidal uptakes. Symptom scores and profile of HGMUE were compared between positive and negative scan results using Wilcoxon rank sum test. RESULTS: Three cases of HGMUE were demonstrated by Tc-99m pertechnetate esophageal scan. The size of inlet patch was not different between positive and negative group (p=0.06). Symptom scores were higher in positive group than in negative group (p=0.04). CONCLUSION: Tc-99m pertechnetate esophageal scan is suitable for the detection of HGMUE in patients with pharyngeal or laryngeal symptoms. Positive scan results were well correlated with severe symptom scores regardless of lesion size on endoscopy. "