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A comparison of esophagography and esophageal transit scintigraphy in the evaluation of usefulness of endoscopic pneumatic dilatation in achalasia.

Authors
 J.-J. CHUNG  ;  H. J. PARK  ;  J. S. YU  ;  Y. J. HONG  ;  J. H. KIM  ;  M.-J. KIM  ;  S. I. LEE 
Citation
 ACTA RADIOLOGICA, Vol.49(5) : 498-505, 2008 
Journal Title
 ACTA RADIOLOGICA 
ISSN
 0284-1851 
Issue Date
2008
MeSH
Adolescent ; Adult ; Aged ; Barium ; Catheterization/methods* ; Esophageal Achalasia/therapy* ; Esophagoscopy/methods* ; Esophagus/diagnostic imaging* ; Female ; Humans ; Male ; Middle Aged ; Pressure ; Radiography ; Radionuclide Imaging ; Reproducibility of Results ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome
Keywords
Esophageal achalasia ; esophagus ; motility ; gastrointestinal tract ; radiography ; radionuclide imaging ; transit studies
Abstract
BACKGROUND: Esophageal transit scintigraphy and barium esophagography have been used for evaluation of therapeutic results in patients with achalasia. It remains to be determined which method is most useful, and whether both studies are necessary before and after treatment for achalasia. PURPOSE: To evaluate the usefulness of both esophagography and esophageal transit scintigraphy (ETS) to determine the efficacy of endoscopic pneumatic dilatation (EPD) in patients with achalasia. MATERIAL AND METHODS: Seventeen patients (6 M, 11 F) with achalasia underwent both esophagography and ETS before and after EPD. Esophagographic findings were reviewed to determine the length and caliber of stenosis in the esophagogastric channel. Dynamic images of ETS were evaluated on time-activity curves. Changes in the clinical symptom score were evaluated. Statistical analyses of esophagography and ETS before and after EPD were performed. RESULTS: After EPD, the mean symptom score improved (P<0.05). The mean residue of radioisotope in ETS also improved after EPD, with a statistically significant correlation (P<0.05). There was a statistically significant correlation between the improved symptom scores and the change in ETS after EPD (P<0.05). There was no statistical correlation between clinical symptom scores and esophageal caliber, regardless of EPD (P>0.05). With an 8-mm diameter of the esophagogastric channel as a benchmark for successful treatment, there was no statistical correlation between esophagography and ETS at 15 s after EPD (P>0.05). CONCLUSION: Esophagography was useful for the evaluation of morphology and caliber of the esophagogastric channel, while ETS was useful for the functional evaluation of esophageal emptying. Both studies may therefore be considered necessary to evaluate the efficacy of EPD in patients with achalasia.
Full Text
http://acr.sagepub.com/content/49/5/498.abstract
DOI
10.1080/02841850802010741
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
Lee, Sang In(이상인)
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106815
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