Volumetric quantification of the gastric emptying: computer-based method for generation of volumetric index from fluoroscopic images.

We developed an automated software-based procedure for estimation of the volume variation of the stomach using videofluoroscopic analysis of the gastric emptying. We used radiological images with postero-anterior incidence of eight healthy volunteers and in vitro experimental tests, with different volumes and concentrations of the contrast medium. This computational method generates an index that measures, in the three dimensions, the dynamic behaviour of gastric emptying. Using adequate contrast concentration (barium sulphate solution), it is possible to determine volume behaviour from density variations. This software can automate this computation, facilitating the amount of work, avoiding mistakes and improving reproducibility.

[Qualitative and quantitative evaluation of gastric emptying using a videofluoroscopic method]. / Avaliação qualitativa e quantitativa do esvaziamento gástrico através do método videofluoroscópico.

We studied the gastric emptying of 21 healthy volunteers using a standard contrasted diet composed of a lipid, carbohydrate, protein and barium sulfate solution homogenate. We did six one-minute videofluoroscopic recordings in a 12-minute interval for the first hour, and in a 30 minute interval until the complete emptying. We selected eight exams for the emptying quantification. We could observe and estimate subjectively the functional behavior and the gastric emptying. Digital representative images of each emptying time point we were able to quantify those observations and describe them as a mathematical function. We developed a macro procedure using the Media Cybernetics ImagePro-Plus software for this quantification. We conclude that: 1--The videofluoroscopic method provides better resolution than the other methods in the analysis of the gastric motility and emptying. 2--It is possible to computationally quantify the morphological differences observed with the sequential registration radiological methods, specially the videofluoroscopic method that generates 30 frames per second. 3--Our results generate a gastric emptying index, based on the area of a gastric projection in radiological images obtained in a standing position over a one-hour period (T1/2). 4--The quantitative analysis should not exclude the qualitative analysis.

[Prolonged esophageal pH monitoring. Evaluation of 170 tests]. / pHmetria esofagiana prolongada--avaliação de 170 exames.

The authors present the experience from a university service of 170 outpatients submitted to 24-hour esophageal pH recording. Indications were: typical symptoms such as heartburn (67 patients), with and without endoscopic esophagitis, chest pain (65 patients; 40% had normal coronariography), a select group with dysphagia (28), besides eight asthmatics, one chronic intractable hiccups, and one esophageal ulcer. There was abnormal reflux in 47% of the total group. pH recording showed abnormal results in 86% of patients presenting heartburn and esophagitis and in 50% of patients without esophagitis. In the chest pain group, 37% had abnormal reflux, but pain with reflux episode could be observed only in 1/5 of them. Twenty percent of dysphagia patients had pathologic reflux and 50% among asthmactics, but the number of patients is small. Authors emphasize the importance of pHmetry as a diagnostic tool and suggest that it is important the knowledge of reflux pattern in healthy Brazilian people.