Four-dimensional impedance manometry volume metrics for predicting abnormal bolus retention.
Neurogastroenterol Motil
; 36(7): e14803, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38676387
ABSTRACT
BACKGROUND:
The objective measurement for esophageal bolus volume and bolus clearance could classify abnormal high-resolution manometry (HRM) beyond the current Chicago classification. We aimed to compare the novel four-dimensional impedance manometry (4D HRM) volume metrics with timed barium esophagram (TBE).METHODS:
Adults with esophageal symptoms undergoing HRM and TBE were included. A custom-built program for 4D HRM analysis measured esophageal luminal cross-sectional area (CSA) from impedance and subsequently derived esophageal bolus volume and clearance. 4D HRM volume metrics included pre-swallow residual volume, maximal volume, retention volume, and clearance ratio defined as 1.0-retention volume divided by the maximal volume. An abnormal TBE was defined as a column height >5 cm at 1 min or 5 min. KEYRESULTS:
A total of 95 patients (normal motility 33%; ineffective esophageal motility 12%; absent contractility 10%; esophagogastric junction outflow obstruction 30%; type I achalasia 5%; type II achalasia 12%) were categorized into normal TBE (58%), abnormal TBE at 1 min (17%), and abnormal TBE at 5 min (25%). The AUROC demonstrated that, among all 4D HRM volume metrics, the clearance ratio had the best performance in predicting abnormal TBE at 5 min (AUROC, 95% confidence interval 0.89, 0.82-0.96), and exhibited a strong negative correlation with TBE at 5 min (r = -0.65; p < 0.001). CONCLUSIONS & INFERENCES Novel 4D HRM volume metrics provide objective measurement of esophageal bolus volume and bolus clearance. The clearance ratio has a strong correlation with TBE and could potentially serve as a substitute for TBE to measure esophageal retention.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Transtornos da Motilidade Esofágica
/
Impedância Elétrica
/
Manometria
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article