Abstract:Background/Aim:This study was conducted to provide sonographic measurements of the abdominal esophagus length in neonates and infants with and without gastroesophageal reflux disease (GERD) and to investigate its diagnostic value. GERD severity was also evaluated and correlated with esophageal length. It is a prospective case-control study.Materials and Methods:This prospective case-control study comprised 235 neonates and infants (120 without reflux and 115 with reflux). There were 40 children without reflux … Show more
“…Videos were recorded right after water-drinking for at least 5 min. Frozen photos and SWE images were also saved after 5-min recording [ 23 ]. Fig.…”
Background
The esophagus involvement in systemic sclerosis (SSc) is very common yet underestimated due to the lack of suitable screening tools. This study aims to explore the usefulness of ultrasound (US) in the assessment of esophagus involvement and to identify its relationship with clinical and CT manifestations.
Methods
We performed transabdominal esophageal US in 38 SSc patients and 38 controls. US parameters including the abdominal esophagus length, esophagus wall thickness, shear-wave elastography, gastro-esophageal (His) angle, and reflux were compared. Relationships between distinguishable US parameters and clinical/CT parameters, such as gastro-esophageal reflux disease questionnaire (GERDQ), modified Rodnan skin score (mRSS), interstitial lung disease (ILD) score, the largest esophagus diameter (Dmax), and esophagus dilation percentage (%Eop), were evaluated.
Results
Abdominal esophagus length was shorter in the SSc group than the control group (2.69 cm vs 3.06 cm, P = 0.018), whereas His angle and the angle change before and after drinking water were larger in the SSc group than the control group (121° vs 108°, P < 0.001; 7.97° vs 2.92°, P = 0.025). Reflux was more frequently seen in the SSc group than the control group (7/38 vs 0/38; P = 0.017). As for correlation with clinical and CT parameters, His angle was higher in patients with GERDQ ≥ 8 than GERDQ < 8 (116.5° vs 125.6°, P = 0.035). Patients with reflux showed higher ILD score than patients without (15.8 vs 9.6, P = 0.043). Furthermore, abdominal esophagus length was negatively correlated with %Eop and Dmax (r = − 0.573, P < 0.001; r = − 0.476, P = 0.003).
Conclusion
US parameters of the esophagus can distinguish SSc patients from controls, as well as have correlations with clinical and CT characteristics. Our pilot study first shows that US can be used as a noninvasive and convenient method to evaluate the esophagus involvement in SSc.
“…Videos were recorded right after water-drinking for at least 5 min. Frozen photos and SWE images were also saved after 5-min recording [ 23 ]. Fig.…”
Background
The esophagus involvement in systemic sclerosis (SSc) is very common yet underestimated due to the lack of suitable screening tools. This study aims to explore the usefulness of ultrasound (US) in the assessment of esophagus involvement and to identify its relationship with clinical and CT manifestations.
Methods
We performed transabdominal esophageal US in 38 SSc patients and 38 controls. US parameters including the abdominal esophagus length, esophagus wall thickness, shear-wave elastography, gastro-esophageal (His) angle, and reflux were compared. Relationships between distinguishable US parameters and clinical/CT parameters, such as gastro-esophageal reflux disease questionnaire (GERDQ), modified Rodnan skin score (mRSS), interstitial lung disease (ILD) score, the largest esophagus diameter (Dmax), and esophagus dilation percentage (%Eop), were evaluated.
Results
Abdominal esophagus length was shorter in the SSc group than the control group (2.69 cm vs 3.06 cm, P = 0.018), whereas His angle and the angle change before and after drinking water were larger in the SSc group than the control group (121° vs 108°, P < 0.001; 7.97° vs 2.92°, P = 0.025). Reflux was more frequently seen in the SSc group than the control group (7/38 vs 0/38; P = 0.017). As for correlation with clinical and CT parameters, His angle was higher in patients with GERDQ ≥ 8 than GERDQ < 8 (116.5° vs 125.6°, P = 0.035). Patients with reflux showed higher ILD score than patients without (15.8 vs 9.6, P = 0.043). Furthermore, abdominal esophagus length was negatively correlated with %Eop and Dmax (r = − 0.573, P < 0.001; r = − 0.476, P = 0.003).
Conclusion
US parameters of the esophagus can distinguish SSc patients from controls, as well as have correlations with clinical and CT characteristics. Our pilot study first shows that US can be used as a noninvasive and convenient method to evaluate the esophagus involvement in SSc.
“…There have been a number of studies which have looked at the role of ultrasound in the diagnosis of GOR and have concluded that it is the test of choice for symptomatic children. Various sonographic indicators of GOR have been proposed including measurement of the length of the abdominal oesophagus, 10–13 assessment of the oesophageal diameter, 14,15 assessment of the oesophageal wall thickness 10,16 and evaluation of the gastro‐oesophageal angle (His angle) 11 . While all these above mentioned measurements are important diagnostic indicators of GOR, we have found that the sonographic diagnosis can be more easily confirmed by real‐time (functional) assessment of the gastroesophageal junction and the visualisation of retrograde passage of gastric contents into the distal abdominal oesophagus 17 .…”
Advances in ultrasound technology and development of higher frequency transducers have enabled ultrasound to have a greater role in the evaluation of stomach pathology in children.1 Since Teele and Smith first described the use of ultrasound in the diagnosis of hypertrophic pyloric stenosis (HPS) in five infants in 1977, ultrasound has been the examination of choice for diagnosis of HPS and in most institutions has completely replaced fluoroscopy for this purpose.2 The obvious advantage of using ultrasound is the avoidance of ionising radiation. Another advantage of ultrasound is its ability to provide valuable information about the stomach wall and surrounding structures. It is important to recognise the many sonographic appearances of the normal stomach so that they are not interpreted as some sort of pathology. The principal aim of this article is to describe the normal and pathologic appearances of the neonatal stomach and potential interpretation pitfalls. Sonographic technique as performed in our institution is also briefly described.
“…[1] The study found that neonates and infants with reflux had a significantly shorter abdominal esophagus than subjects without reflux.However, this study has several critical methodological flaws that I would like to summarize in the following points:…”
mentioning
confidence: 99%
“…I have read with great interest the article by Dehdashti et al utilizing the sonographic measurement of abdominal esophageal length as a tool towards the diagnosis of gastroesophageal reflux disease (GERD) in infants and neonates. [ 1 ] The study found that neonates and infants with reflux had a significantly shorter abdominal esophagus than subjects without reflux.However, this study has several critical methodological flaws that I would like to summarize in the following points:…”
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