식도운동이상 진단에 있어서 Marshmallow 식도조영술의 임상적 가치

Abstract

Background/Aims : We reported previously that marshmallow esophagography was more sensitive than conventional esophagography in evaluation of esophageal symptoms. To verify our previous study, we have investigated the clinical value of marshmallow esophagography in detecting esophageal dysmotility. Methods : Seventy-eight symptomatic patients who showed no organic disorders on esophagoscopy or conventional esophagography nderwent esophageal manometry and marshmallow esophagography within one week. Forty-one of the patients also underwent esophageal transit scintigraphy. Marshmallow transit was considered normal when it passed the esophagus within 30 seconds on the supine position. Abnormal marshmallow transit was graded as mild, moderate, and severe. Results : The results of esophageal manometry were normal in 30 of 52 (57.7%) subjects with normal marshmallow transit, whereas the results were abnormal in 19 of 26 (73.1%) patients with abnormal marshmallow transit (χ2=5.405, p=0.02). The grade of marshmallow transit was correlated to the degree of esophageal dysmotility manometrically (χ2M-H=7.588, p<0.01). The percentage of abnormal marshmallow transit was significantly higher in patients with achalasia, diffuse esophageal spasm, or non-specific esophageal motility disorder than in normal subjects. The grade of marshmallow transit was correlated with the scintigraphic residual fractions. Conclusion : These findings support that marshmallow esophagography would be useful as one of good functional methods for detecting esophageal dysmotility.