Measurement Of Gastric Emptying By Three-dimensional Ultrasonography Using Vocal In Children And Its Application In Pediatric Functional Dyspepsia

Part one Measurements of gastric volumes and gastric emptying by threedimensional ultrasonography using VOCAL technique in ChildrenObjective To investigate feasibility of virtual organ computer-aided analysis(VOCAL) by three-dimensional ultrasonography(3D US) for measurements of gastric volumes(GVs) and gastric emptying times(GET) in normal children.Methods(1) 60 normal children were recruited while 10 hour fasting and after ingestion of gastrointestinal contrast medium(type of equal echo,250 ml).GVs were measured by two physicians using VOCAL technique seperately.The intraclass correlation coefficient(ICC) and Bland-Altman graphs were used to assess inter- and intraobserver reproducibility and consistency.(2) A total of 168 healthy children were selected in this study.Gastric emptying times were mesasured by 3D US using VOCAL at 25%,50% and 75%.The GET was compared in different gender,age and body mass index group(BMI group), the normal value was preliminary established.Results(1)There was good reproducibility in both the same physician and different physicians.The ICC were 0.956(95%CI,0.927~0.974),0.928(95%CI,0.879~0.957), respectively.Bland-Altman graphs showed that good consistency in both the same physician and different physicians.(2) There were no significant differences in all gastric emptying times between genders,age and BMI group(all P>0.05).The normal value was(48.6 ± 11.7) min.(3) The gastric emptying rate was declined in healthy children after 50 percent emptying.Conclusions(1)3D US VOCAL technique is a promising method for measuring GVs in children for its good reproducibility and consistency.(2) The normal value of gastric emptying half time can be provided a reference forclinical practice.Part two Application of three-dimensional ultrasonography VOCAL technique in Children with functional dyspepsiaObjective To evaluate gastric emptying function of children with functional dyspepsia(FD) and its clinical value.Methods(1) 30 children with FD and 30 normal children were included. Gastric volumes were measured by three-dimensional ultrasonography using VOCAL at different time points.The gastric emptying times were calculated,the different gastric emptying time between FD group and normal group were compared with each other. Children with delayed gastric emptying were rechecked 2 weeks after clinical treatment using gastric motility drugs,and gastric emptying function was evaluated again.The symptom scores was evaluated,the relationship between different symptoms scores and gastric emptying time was analysed.Results(1) There was significant difference between FD group and normal group in both gastric emptying half time(GET1/2)(P=0.002) and gastric residual rate of 2 hour(P<0.001).FD group had a tendency to slow gastric emptying.(2) Correlation analysis showed that there was significant correlation between GET1/2 and gastric residual rate of 2 hour in FD group(r=0.854, P<0.05).(3) GET1/2 related poorly to postprandial fullness, abdominal pain, early satiety, belching.(4) The gastric emptying function in FD children was significantly improved after treatment.Conclusions Three-dimensional ultrasonography VOCAL technique can be used to evaluate gastric emptying function in children with FD and assess curative effect before and after treatment.It can be played a significant role in diagnosing and conducting clinical treatment.