Geatti O, Shapiro B, Fig L M, Fossaluzza V, Franzon R, De Vita S, Giacomuzzi F
Istituto di Medicina Nucleare, Ospedale Civile di Udine, Italy.
Am J Physiol Imaging. 1991;6(2):65-73.
Esophageal involvement by scleroderma is frequent. Investigation by manometry or radiography is invasive and nonphysiological. Scintigraphy of the clearance of small radiolabelled liquid boluses in the supine position, while sensitive and noninvasive, may also be nonphysiological and does not allow the simultaneous determination of gastric emptying. We thus studied the esophageal clearance of a semisolid test meal ingested in the upright position. Forty-seven patients with scleroderma and 24 with Sjogren's syndrome were compared with ten normal controls and ten patients with gastric emptying abnormalities but no esophageal involvement. Results of scintigraphy were also correlated with manometry and contrast radiography. Quantitative evaluation of esophageal tracer retention at ten minutes postingestion was: (mean +/- SD), 2.8 +/- 1.0% in normals, 2.9 +/- 0.9% in gastric dysmotility, 4.8 +/- 2.9% in Sjogren's syndrome, and 22.3 +/- 25.0% in scleroderma; similar results were found at 20 and 60 minutes. The T 1/2 of gastric emptying was 47.1 +/- 5.7 minutes in normals, 95.9 +/- 25.3 minutes in gastric dysmotility, 62.9 +/- 19.5 minutes in Sjogren's syndrome, and 52.9 +/- 13.5 minutes in scleroderma. We conclude that esophageal clearance of a semisolid test meal is a sensitive index of esophageal dysmotility and correlates well with results from manometry and contrast radiography but is noninvasive and quantifiable. The simultaneous measurement of gastric emptying is also possible in many cases.
硬皮病累及食管很常见。通过测压法或放射照相术进行检查具有侵入性且不符合生理情况。仰卧位时对小剂量放射性标记液体团块清除情况的闪烁扫描法，虽然灵敏且无创，但也可能不符合生理情况，并且无法同时测定胃排空情况。因此，我们研究了直立位摄入半固体试验餐时的食管清除情况。将47例硬皮病患者和24例干燥综合征患者与10名正常对照者以及10例有胃排空异常但无食管受累的患者进行了比较。闪烁扫描结果还与测压法和造影X线照相术进行了相关性分析。摄入后10分钟时食管示踪剂潴留的定量评估结果为：（平均值±标准差），正常人为2.8±1.0%，胃动力障碍者为2.9±0.9%，干燥综合征患者为4.8±2.9%，硬皮病患者为22.3±25.0%；在20分钟和60分钟时也发现了类似结果。正常情况下胃排空的T1/2为47.1±5.7分钟，胃动力障碍时为95.9±25.3分钟，干燥综合征患者为62.9±19.5分钟，硬皮病患者为52.9±13.5分钟。我们得出结论，半固体试验餐的食管清除是食管动力障碍的一个敏感指标，与测压法和造影X线照相术的结果相关性良好，但具有无创性且可量化。在许多情况下还可以同时测量胃排空情况。
