Clinica Medica, Dipartimento di Medicina Interna, AOU Ospedali Riuniti di Ancona, Italy.
SOD Radiologia Pediatrica e Specialistica, Dipartimento di Scienze Radiologiche, AOU Ospedali Riuniti di Ancona, Italy.
Clin Exp Rheumatol. 2019 Jul-Aug;37 Suppl 119(4):108-114. Epub 2019 Oct 3.
The aim of our study was to assess the role of videofluorography (VFG) in the evaluation of swallowing and oesophageal peristalsis in patients with systemic sclerosis (SSc).
From June 2014 to September 2017, 55 consecutive SSc patients, defined according to the 2013 ACR/EULAR classification criteria, underwent VFG study using a remote-controlled digital device. In order to evaluate possible abnormalities, 18 dynamic parameters were chosen, dividing the act of swallowing into three phases: oral, pharyngeal and oesophageal phases. The following dynamic radiological findings were considered: veil motility in phonation, leakage, drooling, salivation and presence of residues in the oral cavity, pharyngeal residues, penetration, aspiration, altered motility of the upper oesophageal sphincter, efficacy of primary peristaltic contractions, oesophageal clearance capacity, reflux, oesophagitis and motility of the lower oesophageal sphincter.
The VFG study was well tolerated in all patients. Dysfunctions of oesophageal motility were common and included abnormal motility of UES (12.7%) and LES (76.4%), inadequate primary peristalsis (52.7%), abnormal secondary peristalsis (29.1%) and non-peristaltic contractions (40%). A defective oesophageal clearance was observed in 69.4% of patients. Moreover, most patients presented signs of oesophageal reflux (63.6%), oesophagitis (81.8%) and hiatal hernia (80%). Pharyngeal abnormalities were less common and involved up to 50% of patients. Oesophageal dysfunction and defective clearance were associated with dcSSc and pulmonary involvement.
The VFG study is a useful technique for the morphological and functional evaluation of swallowing in SSc patients.
我们研究的目的是评估录像荧光透视术（VFG）在评估系统性硬化症（SSc）患者吞咽和食管蠕动功能中的作用。
从 2014 年 6 月至 2017 年 9 月，55 例连续的 SSc 患者根据 2013 年 ACR/EULAR 分类标准，使用遥控数字设备进行 VFG 研究。为了评估可能的异常，选择了 18 个动态参数，将吞咽动作分为三个阶段：口腔期、咽期和食管期。考虑了以下动态放射学发现：发声时的面纱运动、漏液、流涎、唾液分泌和口腔内残留物、咽腔残留物、穿透、吸入、上食管括约肌运动改变、原发性蠕动收缩效果、食管清除能力、反流、食管炎和下食管括约肌运动。
所有患者均能耐受 VFG 研究。食管运动功能障碍很常见，包括 UES（12.7%）和 LES（76.4%）运动异常、原发性蠕动不足（52.7%）、继发性蠕动异常（29.1%）和非蠕动收缩（40%）。69.4%的患者存在食管清除功能障碍。此外，大多数患者有食管反流（63.6%）、食管炎（81.8%）和食管裂孔疝（80%）的迹象。咽部异常较为少见，约占 50%的患者。食管功能障碍和清除功能障碍与 dcSSc 和肺部受累有关。
VFG 研究是评估 SSc 患者吞咽功能形态和功能的有用技术。
