Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom.
Med Eng Phys. 2012 Apr;34(3):279-89. doi: 10.1016/j.medengphy.2011.07.018. Epub 2011 Aug 17.
Most pathology of the upper gastrointestinal tract now occurs close to the gastro-oesophageal squamo-columnar junction (SCJ). Studying the pathophysiology of this region even using high resolution pH, impedance and manometry is unreliable due to constant movement with respiration, swallowing and transient lower oesophageal sphincter relaxations.
A technique is reported allowing continuous real-time monitoring of the position of the SCJ. It involves endoscopically clipping a magnet (2 mm × 1 mm) to the SCJ and monitoring its position relative to a probe in the oesophago-gastric lumen. The latter has 26 Hall-Effect sensors mounted at 5mm spacing on a circuit board within a silicone tube.
Bench studies: The recorded position of the magnet along the length of the probe was compared with its actual position. Accuracy was related to the distance between magnet and probe, orientation of the magnet relative to the probe and whether the magnet was anterior, posterior or lateral to the probe. Including all possible orientations of the magnet at or nearer than 10mm from the probe, the median accuracy along the length of probe was 2.4 mm (IQR 2.1 mm). The proportion of all possible orientations within 10mm of the probe giving an accuracy of ±10 mm was 88.9%. In vivo studies: With simultaneous fluoroscopy, eight healthy subjects were asked to perform normal breathing, deep breathing, water swallows and finally advancement and retraction of probe over a 12 cm segment. The position recorded by fluoroscopy and probe at each second interval were compared. The correlation co-efficient for all 224 position readings was 0.96 (95% CI: 0.89-0.96). No significant interference was observed when the probe was tested alongside high resolution pH and manometry.
Used in conjunction with high resolution pH, impedance and manometry, this technique will allow for the first time detailed studies at the squamo-columnar junction.
大多数上消化道的病理学现在发生在胃食管鳞柱状交界处（SCJ）附近。即使使用高分辨率 pH 值、阻抗和测压法研究该区域的病理生理学也不可靠，因为它会随着呼吸、吞咽和短暂的食管下括约肌松弛而不断移动。
本文报道了一种允许连续实时监测 SCJ 位置的技术。它涉及在内镜下将一个 2 毫米×1 毫米的磁铁夹在 SCJ 上，并监测其相对于食管胃腔中的探头的位置。后者在硅树脂管内的电路板上有 26 个安装在 5 毫米间隔的霍尔效应传感器。
在台架研究中：将磁铁在探头长度上的记录位置与其实际位置进行比较。准确性与磁铁和探头之间的距离、磁铁相对于探头的方向以及磁铁是在前部、后部还是侧面相对于探头有关。包括在距离探头 10 毫米以内或更近的磁铁的所有可能方向，在探头长度上的平均准确性为 2.4 毫米（IQR 2.1 毫米）。在探头 10 毫米以内的所有可能方向中，有 88.9%的方向能够达到±10 毫米的准确性。在体内研究中：同时进行荧光透视检查，要求八名健康受试者进行正常呼吸、深呼吸、吞咽水，最后推进和缩回探头 12 厘米段。比较每个间隔荧光透视和探头记录的位置。224 个位置读数的相关系数为 0.96（95%置信区间：0.89-0.96）。当探头与高分辨率 pH 值和测压法一起测试时，没有观察到明显的干扰。
与高分辨率 pH 值、阻抗和测压法结合使用，这项技术将首次允许在鳞柱状交界处进行详细研究。
