Esophageal motility: assessment with synchronous video tape fluoroscopy and manometry.

Ott, David J.; Chen, Y M; Hewson, Edward G.; Richter, J. E.; Dalton, Christine B.; Gelfand, DW; Wu, Weiping

doi:10.1148/radiology.173.2.2798872

Cited by 78 publications

(23 citation statements)

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“…Hence manometric recordings alone are insufficient to describe and quantify esophageal motility. To improve this, and gain more knowledge, modalities such as fluoroscopy [5,6] and ultrasound [7] have been used in combination with manometry. These modalities have confirmed that parameters recorded by manometry only partly describe the peristaltic wave, but these imaging modalities do not provide quantitative information on force in either radial or axial directions [8] .…”

Section: Introductionmentioning

confidence: 99%

Axial force measurement for esophageal function testing

Gravesen¹,

Funch‐Jensen²,

Gregersen³

et al. 2009

WJG

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The esophagus serves to transport food and fluid from the pharynx to the stomach. Manometry has been the "golden standard" for the diagnosis of esophageal motility diseases for many decades. Hence, esophageal function is normally evaluated by means of manometry even though it reflects the squeeze force (force in radial direction) whereas the bolus moves along the length of esophagus in a distal direction. Force measurements in the longitudinal (axial) direction provide a more direct measure of esophageal transport function. The technique used to record axial force has developed from external force transducers over in-vivo strain gauges of various sizes to electrical impedance based measurements. The amplitude and duration of the axial force has been shown to be as reliable as manometry. Normal, as well as abnormal, manometric recordings occur with normal bolus transit, which have been documented using imaging modalities such as radiography and scintigraphy. This inconsistency using manometry has also been documented by axial force recordings. This underlines the lack of information when diagnostics are based on manometry alone. Increasing the volume of a bag mounted on a probe with combined axial force and manometry recordings showed that axial force amplitude increased by 130% in contrast to an increase of 30% using manometry. Using axial force in combination with manometry provides a more complete picture of esophageal motility, and the current paper outlines the advantages of using this method.

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Section: Introductionmentioning

confidence: 99%

Axial force measurement for esophageal function testing

Gravesen¹,

Funch‐Jensen²,

Gregersen³

et al. 2009

WJG

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show abstract

“…Our study is also limited by lack of manometric data to corroborate the radiographic assessment of esophageal motility. However, it has been shown that carefully performed¯uoroscopic examinations have an accuracy of greater than 90% in assessing esophageal motility in relation to manometry [10]. In the future, prospective studies comparing the radiographic and manometric ®ndings in patients with epiphrenic diverticula are needed to further delineate the relationship between epiphrenic diverticula, esophageal dysmotility, and clinical symptomatology in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…In all cases, esophageal motility was evaluated at¯uoroscopy by having the patient ingest single swallows of a low-density barium suspension in the prone, right anterior oblique position. As suggested by others [10], esophageal dysmotility was considered to be present if peristalsis was abnormal on two or more of ®ve separate swallows. It was not possible to correlate the radiographic ®ndings with manometric ®ndings, as none of the patients had documentation of manometry in their medical records.…”

Section: Methodsmentioning

confidence: 99%

Epiphrenic Diverticulum: Clinical and Radiographic Findings in 27 Patients

et al. 2003

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The purpose of our study was to reassess the clinical and radiographic findings in patients with epiphrenic diverticula. A search of our radiology files revealed 27 patients with epiphrenic diverticula within 10 cm of the gastroesophageal junction. Medical records and radiographic reports and images were reviewed to determine the clinical and radiographic findings. Twenty-three patients had a solitary epiphrenic diverticulum, three had two diverticula, and one had three diverticula. The diverticula arose from the right side of the distal esophagus in 19 patients and the left side in eight. The diverticula had a mean width of 4.4 cm and a mean height of 3.7 cm. Other findings included prolonged retention of barium in the diverticula in 19 patients, preferential filling in 11, retained debris in 5, regurgitation of barium or debris in 5, compression of the esophagus in 5, pseudodiverticula formation in 3, and ulceration in 1. We found a significant correlation between the width of the diverticulum and preferential filling with barium. Twelve patients had abnormal esophageal motility, with diffuse esophageal spasm in two. Seventeen patients had symptoms attributable to the diverticulum (dysphagia in 11 and/or reflux symptoms in 12). We also found a significant correlation between the size or preferential filling of the diverticulum and the presence of symptoms. Conversely, we found no correlation between esophageal dysmotility and the presence of symptoms. Our experience suggests that the development of symptoms in patients with epiphrenic diverticula is more likely to be related to the morphologic features of the diverticula than to underlying esophageal motility disorders.

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“…Radiographic evaluation of esophageal motility involves observing single swallows of barium with the patient in the prone position [40,41]. A normal primary peristaltic sequence is seen as an aboral contraction wave that obliterates the esophageal lumen, progressively stripping the barium bolus.…”

Section: Esophageal Motility Disordersmentioning

confidence: 99%

“…Proper fluoroscopic examination accurately assesses normal esophageal peristalsis with reported specificities of 91 95% [40,41,46]. Multiple single swallows must be observed with the patient prone to determine the actual incidence of primary peristalsis [41].…”

Section: Esophageal Motility Disordersmentioning

confidence: 99%

Radiographic techniques and efficacy in evaluating esophageal dysphagia

Ott

1990

Dysphagia

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The radiographic examination of the esophagus to determine structural and/or functional causes of dysphagia is best performed with multiple techniques. These include full-column studies to produce distended films with or without the use of a solid bolus, mucosal relief films to identify mucosal defects such as esophagitis or the presence of varices, double-contrast films, and motion recording (fluoroscopy). The efficacy of each technique depends on the quality of the study and the specific disorder to be detected. Esophageal lesions producing dysphagia are classified into extrinsic structural lesions, intrinsic structural lesions, and esophageal motility disorders. Radiographic studies are the preferred screening techniques for patients with dysphagia. Although not as sensitive for the evaluation of mucosal lesions, radiographic studies are superior to endoscopy for the detection of abnormal motility, esophageal rings, and strictures.

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Esophageal motility: assessment with synchronous video tape fluoroscopy and manometry.

Cited by 78 publications

References 0 publications

Axial force measurement for esophageal function testing

Axial force measurement for esophageal function testing

Epiphrenic Diverticulum: Clinical and Radiographic Findings in 27 Patients

Radiographic techniques and efficacy in evaluating esophageal dysphagia

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