Scintigraphic assessment of oesophageal motility: what does it show and how reliable is it?
Computer analysed transit of a liquid bolus containing Tc99m (RT) was compared with manometry for the detection of oesophageal motility disorders in 151 patients with a variety of oesophageal symptoms. Manometry was abnormal in 99 of whom 44 had abnormal RT (sensitivity 44%); it was normal in 52 of whom 37 had normal RT (specificity 71%). The commonest manometric abnormalities were non-specific motility disorders characterised by abnormalities of peristaltic amplitude, waveform or baseline. Radionuclide transit was abnormal in only 32/77 (42%) of these. Achalasia, which is characterised by complete aperistalsis, was the least common diagnosis, but all five cases had abnormal RT. Simultaneous manometry and RT in 30 patients showed that the transit of a liquid bolus through the oesophagus is determined by the propagation rather than the form of the peristaltic contraction. Because non-specific motility disorders are common in clinical practice, RT is not a useful screening test for oesophageal dysmotility.
D004931:Esophageal Achalasia / Q000000981:diagnostic imaging; D004935:Esophageal Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004947:Esophagus / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis; D011877:Radionuclide Imaging; D012588:Scintillation Counting; D013035:Spasm / Q000000981:diagnostic imaging