Esophageal motor disorders: videofluoroscopic and manometric evaluation--prospective study in 88 symptomatic patients.
Esophageal motor disorders are best evaluated with manometry, which, however, is time-consuming and not generally available. The authors prospectively investigated the yield of videofluoroscopy in detection of esophageal motor disorders in comparison with that of manometry. Eighty-eight patients with dysphagia, globus sensation, noncardiac chest pain, or progressive systemic sclerosis underwent both manometry and videofluoroscopy at 0-32-day intervals. Videofluoroscopy was performed with one swallowing study in the upright position and up to three swallowing studies in the prone oblique position. Manometric diagnoses of achalasia (n = 15), diffuse esophageal spasm (n = 1), nonspecific esophageal motor disorders (n = 44), and adynamic esophagus (n = 9) were made. Videofluoroscopically, 87% of the patients with achalasia, the one patient with diffuse spasms, 73% of the patients with nonspecific esophageal motor disorders, and all of the patients with adynamic esophagus received a correct diagnosis, for an overall sensitivity of 80%. The radiographic specificity was 79%. The authors conclude that videofluoroscopy is a valuable and reasonably sensitive technique for screening for esophageal motor disorders.
Schima
W
W
Department of Radiology, University of Vienna, Austria.
Stacher
G
G
Pokieser
P
P
Uranitsch
K
K
Nekahm
D
D
Schober
E
E
Moser
G
G
Tscholakoff
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002933:Cineradiography; D004931:Esophageal Achalasia / Q000175:diagnosis / Q000000981:diagnostic imaging; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D015155:Esophageal Spasm, Diffuse / Q000175:diagnosis / Q000000981:diagnostic imaging; D004943:Esophagogastric Junction / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis / Q000502:physiology; D011312:Pressure; D011446:Prospective Studies; D012680:Sensitivity and Specificity