Montesi A, Pesaresi A, Cavalli M L, Serri L, Salmistraro D, Candela M, Gabrielli A
Servizio di Radiologia, Ospedale regionale, Umberto I, USL 12, Ancona.
Radiol Med. 1990 Sep;80(3):296-300.
Fifty-one patients with systemic sclerosis (scleroderma) were studied by means of videofluoroscopy in order to evaluate the abnormalities in the oropharyngeal and esophageal phases of deglutition and to correlate the radiological patterns with the clinical features of the disease. Thirteen patients (25.5%) exhibited swallowing disorders such as oral leakage, retention, penetration, mild or moderate aspiration and abnormal upper esophageal sphincter behavior. These dysfunctions were more evident in patients with esophageal motility abnormalities. A normal radiological pattern in the esophagus was not associated with swallowing alterations. Remarkably, patients with oral-pharyngeal disorders had a higher incidence of lung diseases. Forty-five patients (88%) exhibited disorders of the esophageal phase of deglutition, such as mild or severe motility abnormalities or hiatal hernia, gastro-esophageal reflux, reflux esophagitis, and stricture. Radiological findings in the esophagus can be abnormal in the early stages of the disease. On the other hand, the radiological pattern of esophageal motility can be occasionally negative in advanced or extensive disease. This indicates a discrepancy between clinical symptoms and radiological picture of the esophagus. The radiological examination of the oral-pharyngeal and esophageal phases of deglutition is important in patients with scleroderma in order to evaluate visceral involvement, motility disorders, and risk of aspiration. Such radiological information can be useful in preventing esophagitis and pulmonary complications.
为了评估吞咽的口咽期和食管期异常，并将放射学模式与系统性硬化症（硬皮病）的临床特征相关联，对51例系统性硬化症患者进行了电视荧光透视检查。13例患者（25.5%）表现出吞咽障碍，如口腔漏出、潴留、穿透、轻度或中度误吸以及食管上括约肌行为异常。这些功能障碍在食管动力异常的患者中更为明显。食管放射学模式正常与吞咽改变无关。值得注意的是，口咽疾病患者肺部疾病的发生率更高。45例患者（88%）表现出吞咽食管期障碍，如轻度或重度动力异常或食管裂孔疝、胃食管反流、反流性食管炎和狭窄。食管的放射学表现可在疾病早期出现异常。另一方面，在疾病晚期或广泛期，食管动力的放射学模式偶尔可能为阴性。这表明食管的临床症状与放射学表现之间存在差异。对系统性硬化症患者进行吞咽的口咽期和食管期放射学检查对于评估内脏受累、动力障碍和误吸风险很重要。此类放射学信息有助于预防食管炎和肺部并发症。
