Abstract |
The author performed radionuclide esophageal transit
studies(RETS) with liquid and solid boluses using the
same day protocol in 90 normal controls and 164
patients with various primary esophalgeal motility
disorders who were diagnosed by manometric criteria and
clinical courses. The authors calculated mean
esophageal transit time(MTT) and mean residual
retention(MRR) in each of the liquid and solid studies,
and classified time-activity curve(TAC) patterns. The
normal criteria of RETS with liquid bolus were MTT〈24
sec, MRR〈9%, and the TAC pattern that showed rapid
declining slope and flat low residual(Type 1). The
normal criteria of RETS with solid bolus were MTT〈35
sec, MRR〈9% and TAC of type 1. With these normal
criteria, the sensitivity and the specificity of the
liquid study were 62.2% and 97.8%, respectively. The
sensitivity increased to 75.4% with the solid study.
The author also found that the RETS was highly
reproducible. The achalasia typically shoewed no
effective emptying of both liquid and solid boluses
during the whole study period, and was well
differentiated by its extremely long transit time and
high retention from the other motility disorders. The
diffuse esophageal spasm(DES) and nonspecific
esophageal motility disorder(NEMD) showed intermediate
delay in tranit time and increased retention. In the
groups of hypertensive lower esophageal sphincter(LES),
hypotensive LES and nutcracker, there noted no
significant difference with the normal control group in
terms of MTT and MRR. The DES and NEMD could be more
easily identified by solid studies that showed more
marked delay in MTT and increased MRR as compared with
the liquid study. In conclusion, esophageal
scintigraphy is a safe, noninvasive and physiologic
method for the evaluation of esophageal emptying. |