a Gastrointestinal Unit, Department of Surgery, Oncology and Gastroenterology , University of Padua , Padua , Italy.
b Gastrointestinal Unit, Department of Internal Medicine and Medical Specialties , University of Genoa , Genoa , Italy.
Expert Rev Gastroenterol Hepatol. 2019 May;13(5):425-435. doi: 10.1080/17474124.2019.1595587. Epub 2019 Mar 21.
The utilization of high-resolution manometry (HRM) has enhanced our understanding and assessment of esophageal motor disorders. Moreover, the combination of impedance technology with HRM (HRIM) has further improved our knowledge of esophageal physiology and the clinical evaluation of dysmotility, thanks to the addition of accurate measurement of bolus transit. Areas covered. This paper provides an overview of current knowledge in the use of HRIM for the study of esophageal functional disorders by reporting mainly the results of many publications and several systematic reviews in this field. Expert opinion. HRIM has represented a relevant improvement in the assessment of esophageal motility and has required the development of new metrics, such as the esophageal impedance integral ratio, the bolus flow time, the nadir impedance pressure and the impedance bolus height, which increase the evaluation of esophageal bolus transit. An extension of impedance is represented by functional lumen imaging probe (FLIP), which determines the biophysical properties and the distensibility of the esophagus and permits to detect contractility patterns not seen on HRM alone. We eagerly wait for a new and fruitful iteration of the Chicago Classification, now in version 3.0, which can cover the ongoing clinical experience of HRIM.
高分辨率测压（HRM）的应用增强了我们对食管动力障碍的理解和评估。此外，阻抗技术与 HRM（HRIM）的结合，通过对食团传输的精确测量，进一步提高了我们对食管生理学的认识和对运动障碍的临床评估。涵盖领域。本文通过主要报告该领域的许多出版物和几项系统评价的结果，概述了 HRIM 在食管功能障碍研究中的应用的最新知识。专家意见。HRIM 对食管动力的评估有重要的改进，并要求开发新的指标，如食管阻抗积分比、食团通过时间、最低阻抗压力和阻抗食团高度，这些指标增加了对食管食团传输的评估。阻抗的扩展由功能腔成像探头（FLIP）表示，它确定了食管的生物物理特性和可扩张性，并允许检测到仅在 HRM 上看不到的收缩模式。我们急切地等待着芝加哥分类的新版本（现在是 3.0 版），它可以涵盖 HRIM 的临床经验。
