Subject(s)
Fetal Diseases/diagnostic imaging , Imaging, Three-Dimensional , Mediastinal Neoplasms/diagnostic imaging , Teratoma/diagnostic imaging , Ultrasonography, Prenatal , Adult , Female , Fetal Diseases/surgery , Humans , Mediastinal Neoplasms/complications , Mediastinal Neoplasms/surgery , Polyhydramnios/etiology , Pregnancy , Teratoma/complications , Teratoma/surgeryABSTRACT
AIMS: To develop a simple technique for examination of the oesophagus by digital radiography and to assess its role in the evaluation of motility disorders of the oesophagus. MATERIALS AND METHODS: Forty-nine patients and 44 control subjects underwent manometry and digital examination of the oesophagus. The digital study consisted of two parts: firstly examination of the pharynx and cervical oesophagus using 15 ml of fluid barium in anterio-posterior (AP) and lateral views, with image acquisition of four frames/s for 2 s. Secondly, examination of the thoracic oesophagus and oesophagogastric junction using 25 ml of barium in two prone oblique and one supine AP series, with image acquisition of one frame/s for 20 s. Oesophageal transit time (OTT) was measured in each case. Abnormal or non-peristaltic contractions were described regarding their morphology, time of visualization and length. The presence or absence of hiatal hernia, reflux or any associated organic lesions was noted. RESULTS: Digital radiography diagnosed 14 cases of achalasia and 28 cases of non-specific oesophageal motility disorder (NOMD). Normal OTT was 11.95 +/- 1.304 s. The OTT was prolonged (16 s or more) in all patients except five; four of these were cases of NOMD. Abnormal contractions were classified into circular and longitudinal types. The circular non-obliterating type was commoner. Achalasia was diagnosed in all cases, as failure of relaxation of the inferior oesophageal sphincter was always present and easily depicted by digital radiography. Abnormal contractions in the body of the oesophagus were elicited in 57% of cases of achalasia. The sensitivity of digital radiography in detecting oesophageal motility disorders was 85.7% based on the presence of abnormal contractions and 91.6% by eliciting a prolonged OTT. CONCLUSIONS: Examination of the oesophagus by digital radiography is simple, non-invasive, reproducible, rapid and without discomfort to patients. It allows the diagnosis of motility disorders of the oesophagus by detecting abnormal contractions and/or prolonged OTT and showed any associated organic lesions.Aly, Y. A. (2000). Clinical Radiology 55, 561-568.
Subject(s)
Esophageal Motility Disorders/diagnostic imaging , Radiographic Image Enhancement/methods , Adolescent , Adult , Aged , Case-Control Studies , Female , Gastrointestinal Transit/physiology , Humans , Male , Manometry/methods , Middle Aged , Prospective Studies , Sensitivity and SpecificityABSTRACT
OBJECTIVE: To develop a simple radiological technique for measuring normal oesophageal transit time. DESIGN: 72 patients with no oesophageal or gastrointestinal complaints underwent manometry and radiological oesophageal transit time (ROTT). ROTT was perfomed using 2 ml of fluid barium on a digital X-ray machine. Digital image acquisition started with the beginning of swallowing using 1 frame/s for 15 s. These images were printed on a single film. The effect of ageing on ROTT was also assessed. RESULTS: ROTT had a mean value of 10.08 s. ROTT was divided into three segments: proximal-to-left-main-bronchus; retrocardiac; and inferior oesophageal sphincter segments. The mean transit time across these segments was 2.84, 3.07, and 4.15 s, respectively. ROTT in patients over 40 years was longer than in patients under 40 years. CONCLUSION: ROTT is a physiological, rapid, non-invasive, and reproducible technique for measuring the normal oesophageal transsit time, without discomfort to patients.