[Esophageal scintigraphy of Zenkers diverticula before and after diverticulotomy]
Frahm C. Bahre M. Ahrens KH. Eckerle S. Sommer K. Frahm C. Richter E.
Klinik fur Strahlentherapie und Nuklearmedizin, Medizinischen Universitat zu Lubeck, Deutschland.
AIM: The filling and evacuation of Zenker's diverticula were scintigraphically examined before and after operation to quantify their functional relevance. These results were correlated with the symptoms of the patients and the findings of the barium swallow x-ray examination using cineradiography. METHODS: Sequential and static esophageal scintigraphies were performed in 17 patients with Zenker's diverticulum before and after laser surgical diverticulotomy. We used a gamma camera system in 45 degrees LAO-position after application of 15 ml of tea which was marked with 99mTc-DTPA. Filling and evacuation of the diverticulum were expressed in proportion to the administered activity. Relative volumes of the diverticula were obtained from cineradiography by using the height of the neighbouring cervical vertebra, and the clinical symptoms were divided into 4 groups. RESULTS: Zenker's diverticula could be verified visually and quantitatively by scintigraphy. The precise temporal course of the reduction of activity in the diverticulum was exactly determined. The scintigraphic retentions correlated with the x-ray volumes with a coefficient ranging from 0.55 to 0.85. Clinical symptoms also were not very closely related to scintigraphic and x-ray findings, respectively. CONCLUSION: The esophageal scintigraphy allows quantification of the filling and evacuation of Zenker's diverticula, thus it is suitable for objectivization of the functional relevance of the diverticula. That's why the esophageal scintigraphy should be taken to the diagnosis of diverticula in addition to the clinic and the x-ray examinations. The method is especially useful to evaluate the results after diverticulotomy.