Gastric activity on dipyridamole²⁰¹T1 myocardial perfusion imaging: A clinically useful finding

To determine the potential association of increased²⁰¹T1 uptake by the stomach with symptoms referable to gastritis, 39 consecutive patients experiencing chest pain syndromes underwent a routine dipyridamole²⁰¹T1 pharmacological stress test. With the patient in a fasting state, dipyridamole was infused intravenously (0.56 mg kg^-1), shortly followed by²⁰¹T1 infusion and subsequent image acquisition for single photon emission tomography (SPET). The original 32 SPET images over 180° of arc were interpreted without knowledge of clinical data, using a 4-point scoring system. Patients with active symptoms of gastro-oesophageal discomfort (n=17) were found to have significantly greater²⁰¹T1 stomach uptake scores, compared to the little or no uptake in the 22 patients without such active symptoms (P=0.0001). A stepwise logistic regression analysis was used to determine which factor(s) showed independent predictive value of²⁰¹T1 gastric uptake. The only two independent variables identified were the presence of active gastritis symptoms and the use of anti-gastritis medications. Elevated gastric²⁰¹T1 uptake may be a clinically useful finding indicative of gastric inflammation that may be of value in the differential diagnosis of chest and epigastric discomfort.