Classification schema of symptomatic enterogastric reflux utilizing sincalide augmentation on hepatobiliary scintigraphy

Matthew F. Covington, Elizabeth Krupinski, Ryan J. Avery, Phillip H. Kuo

Research output: Contribution to journalArticle

6 Scopus citations


Enterogastric reflux (EGR) is the reflux of duodenal contents into the stomach. Hepatobiliary scintigraphy provides physiologic assessment of the biliary system and was used to test the hypothesis that presence and timing of EGR may be associated with infusion of sincalide, a surrogate of endogenous cholecystokinin. Methods: One hundred fifty-seven hepatobiliary scintigraphy studies were retrospectively reviewed. Data included EGR incidence on initial reports, incidence after masked second reads, and time of EGR onset in relation to sincalide infusion. EGR cases were then classified according to onset on prepost-, or both presincalide and postsincalide imaging. Results: Time of EGR onset at 19-24 minutes after start of a 15-min sincalide infusion differed significantly from normal (p<0.0001). EGR was initially reported in 14 of 157 cases (8.9%) but found in 38 of 157 cases on masked second reads (24.2%), corresponding to a 15.3% discrepancy rate. Conclusion: The temporal association of EGR onset with sincalide infusion may identify patients with EGR mimicking chronic cholecystitis or biliary dyskinesia. A novel classification schema was therefore developed as a framework for future research, utilizing EGR onset in relation to prepost-, or both presincalide and postsincalide imaging as a hypothetical biomarker of clinically significant EGR.

Original languageEnglish (US)
Pages (from-to)198-202
Number of pages5
JournalJournal of nuclear medicine technology
Issue number3
StatePublished - Jan 1 2014



  • Bile reflux
  • Enterogastric reflux
  • HIDA scan
  • Hepatobiliary scintigraphy
  • Sincalide

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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