Carlson D A, Lin Z, Rogers M C, Lin C Y, Kahrilas P J, Pandolfino J E
Department of Medicine, Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Neurogastroenterol Motil. 2015 Jul;27(7):981-9. doi: 10.1111/nmo.12572. Epub 2015 Apr 20.
The functional lumen imaging probe (FLIP) measures luminal cross-sectional area and pressure during volumetric distension. By applying novel customized software to produce FLIP topography plots, organized esophageal contractility can be visualized and analyzed. We aimed to describe the stimulus thresholds and contractile characteristics for distension-induced esophageal body contractility using FLIP topography in normal controls.
Ten healthy controls were evaluated during endoscopy with FLIP. During stepwise bag distension, simultaneous intra-bag pressure and luminal diameter measurements were obtained and exported to a MatLab program to generate FLIP topography plots. The distension volume, intra-bag pressure, and maximum esophageal body diameters were measured for the onset and cessation of repetitive antegrade contractions (RACs). Contraction duration, interval, magnitude, and velocity were measured at 8 and 3-cm proximal to the esophagogastric junction.
Eight of ten subjects demonstrated RACs at a median onset volume of 29 mL (IQR: 25-38.8), median intra-bag pressure of 10.7 mmHg (IQR: 8.6-15.9), and median maximum esophageal body diameter of 18.5 mm (IQR: 17.5-19.6). Cessation of RACs occurred prior to completion of the distension protocol in three of the eight subjects exhibiting RACs. Values of the RAC-associated contractile metrics were also generated to characterize these events.
CONCLUSIONS & INFERENCES: Distension-induced esophageal contractions can be assessed utilizing FLIP topography. RACs are a common finding in asymptomatic controls in response to volume distention and have similar characteristics to secondary peristalsis and repetitive rapid swallows.
功能性管腔成像探头（FLIP）在容积扩张过程中测量管腔横截面积和压力。通过应用新型定制软件生成FLIP地形图，可以可视化和分析有组织的食管收缩性。我们旨在使用FLIP地形图描述正常对照中扩张诱导的食管体收缩性的刺激阈值和收缩特征。
在内镜检查期间使用FLIP对10名健康对照进行评估。在逐步气囊扩张过程中，同时获得气囊内压力和管腔直径测量值，并导出到MatLab程序中以生成FLIP地形图。测量重复顺行收缩（RACs）开始和停止时的扩张体积、气囊内压力和最大食管体直径。在食管胃交界处近端8 cm和3 cm处测量收缩持续时间、间隔、幅度和速度。
10名受试者中有8名表现出RACs，中位起始体积为29 mL（IQR：25 - 38.8），中位气囊内压力为10.7 mmHg（IQR：8.6 - 15.9），中位最大食管体直径为18.5 mm（IQR：17.5 - 19.6）。在表现出RACs的8名受试者中，有三名在扩张方案完成之前RACs停止。还生成了与RAC相关的收缩指标值以表征这些事件。
可以利用FLIP地形图评估扩张诱导的食管收缩。RACs是无症状对照中对容积扩张的常见反应，并且具有与继发性蠕动和重复快速吞咽相似的特征。
