Min Young-Kee, Baek Sora, Kang Eun Kyoung, Nam Seung-Joo
Department of Rehabilitation Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Ann Rehabil Med. 2020 Feb;44(1):38-47. doi: 10.5535/arm.2020.44.1.38. Epub 2020 Feb 29.
To evaluate the prevalence rate, types, characteristics, and associated factors of esophageal dysphagia detected on chest X-ray images after videofluoroscopic swallowing study (VFSS).
The medical records of 535 adults were reviewed retrospectively. Chest X-ray images taken after barium swallow study were analyzed and presence of any residual barium in the esophagus was considered as esophageal dysphagia. Esophageal dysphagia was classified based on the largest width of barium deposit (mild, <2 cm; severe ≥2 cm) and the anatomic level at which it was located (upper and lower esophagus).
Esophageal residual barium on chest X-ray images was identified in 40 patients (7.5%, 40/535). Esophageal dysphagia was more frequent in individuals aged 65-79 years (odds ratio=4.78, p<0.05) than in those aged <65 years. Mild esophageal dysphagia was more frequent (n=32) than its severe form (n=8). Lower esophageal dysphagia was more frequent (n=31) than upper esophageal dysphagia (n=9). Esophageal residual barium in patients diagnosed with esophageal cancer or lung cancer was significantly associated with severe esophageal dysphagia (p<0.05) and at the upper esophagus level (p<0.01).
Esophageal residual barium was observed on chest X-ray imaging after VFSS. Esophageal barium in the upper esophagus with a diameter of ≥2 cm is an important indicator of malignancy, and chest X-ray image taken after VFSS is an important step to evaluate the presence of esophageal disorder.
评估电视荧光吞咽造影检查（VFSS）后胸部X线图像上检测到的食管吞咽困难的患病率、类型、特征及相关因素。
回顾性分析535例成年人的病历。对吞钡检查后拍摄的胸部X线图像进行分析，食管内任何残留钡剂均被视为食管吞咽困难。食管吞咽困难根据钡剂沉积的最大宽度（轻度，<2 cm；重度，≥2 cm）及其所在的解剖部位（食管上段和下段）进行分类。
40例患者（7.5%，40/535）胸部X线图像上发现食管残留钡剂。65 - 79岁个体的食管吞咽困难比<65岁个体更常见（比值比=4.78，p<0.05）。轻度食管吞咽困难比重度更常见（n = 32）（n = 8）。食管下段吞咽困难比上段更常见（n = 31）（n = 9）。诊断为食管癌或肺癌的患者食管残留钡剂与重度食管吞咽困难（p<0.05）及食管上段水平（p<0.01）显著相关。
VFSS后胸部X线成像观察到食管残留钡剂。食管上段直径≥2 cm的钡剂是恶性肿瘤的重要指标，VFSS后拍摄的胸部X线图像是评估食管疾病存在的重要步骤。
