title: Lack of utility of transabdominal ultrasound in the detection of gastroesophageal reflux disease-induced esophagitis in comparison with endoscopy.
abstract: BACKGROUND
  Although upper gastrointestinal (GI) tract endoscopy is the investigation of choice for patients with suspected gastroesophageal reflux disease (GERD)-induced esophagitis, it is associated with complications and significant patient discomfort. The aim of the current study was to compare the accuracy of transabdominal ultrasonography with upper GI tract endoscopy in the detection of GERD-induced esophagitis.
  
  
  METHODS
  In this descriptive study, 350 patients (mean age, 41.41 ± 14.52 years) referred to a gastroenterologist with symptoms suggestive of GERD were enrolled. The esophageal wall thickness was measured with transabdominal ultrasonography, and patients were subsequently assessed by upper GI endoscopy, representing the criterion standard in the diagnostic evaluation for GERD-induced esophagitis.
  
  
  RESULTS
  Endoscopic evaluation identified 100 patients with esophagitis (case group), and 250 subjects were reported to have normal endoscopic findings (control group). The wall thickness was significantly higher in the case group compared with the control (P < 0.0001).In the receiver operating characteristic analysis, only 2 cutoff points had a positive predictive value (PPV) greater than 50%. The cutoff point of 2.7 mm had 38% sensitivity, 91% specificity, 63% PPV, and 79% negative predictive value in the detection of GERD. Its positive and negative likelihood ratios were 4.32 and 0.68, respectively.
  
  
  CONCLUSIONS
  According to the identified sensitivity/specificity, low PPV and positive likelihood ratio, and relatively high negative likelihood ratio, we failed to find the transabdominal ultrasound effective in the detection of GERD-induced esophagitis.
authors: Department of Radiology, Imam Training Hospital, Urmia, Iran.
authors: Afshin
authors: A
authors: Mohammadi
authors: Masoud
authors: M
authors: Sadreddini
authors: Nariman
authors: N
authors: Sepehrvand
authors: Armin
authors: A
authors: Pedram
authors: Nasim
authors: N
authors: Yarmohammadi
authors: Nikol
authors: N
authors: Mladkova
authors: Mohammad
authors: M
authors: Ghasemi-Rad