Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Neurogastroenterol Motil. 2020 Jul;32(7):e13847. doi: 10.1111/nmo.13847. Epub 2020 Apr 16.
Esophageal bolus transit can be assessed using esophagogram or high-resolution impedance manometry (HRIM). The three-dimensional volume of inverted impedance (VII) has been developed to quantify the residual bolus between each swallow through spatiotemporal analysis. However, this novel metric has not been validated against simultaneous esophagogram.
A total of nine healthy volunteers (Seven males, aged 19-45 years) were prospectively evaluated with HRIM and barium esophagogram. In addition, 21 symptomatic patients (12 males, aged 20-85 years) without major motility disorder were also included. The VII was estimated from HRIM data using MATLAB program and was compared with residual bolus volume in the esophagus estimated from simultaneous esophagogram.
A total of 80 swallows (24 in controls and 56 in patients) were analyzed. Results from the VII method were concordant with the bolus transit pattern estimated from the esophagogram in 91.3% (73/80) of swallows. The correlation between quantitative data from VII and the volume of residual bolus estimated from esophagogram was strong in both groups with a Pearson's correlation coefficient of 0.805 for healthy volunteers and 0.730 for symptomatic patients. The intraclass correlation coefficient of VII between the three swallows within a subject was 0.901 in healthy subjects and 0.705 in patients, indicating a modest reliability of this method.
The newly developed VII method is a reliable method in assessing residual bolus volume in the esophagus based on comparison with bolus volume estimated from simultaneous esophagogram.
食管食团转运可通过食管造影或高分辨率阻抗测压（HRIM）进行评估。三维反转阻抗容积（VII）已被开发出来，通过时空分析来量化每次吞咽之间的残余食团。然而，这种新的测量方法尚未与同时进行的食管造影进行验证。
共前瞻性评估了 9 名健康志愿者（7 名男性，年龄 19-45 岁）和 HRIM 与钡剂食管造影。此外，还纳入了 21 名无主要运动障碍的症状性患者（12 名男性，年龄 20-85 岁）。VII 通过 MATLAB 程序从 HRIM 数据中估算，并与同时进行的食管造影估计的食管中残余食团体积进行比较。
共分析了 80 次吞咽（对照组 24 次，患者组 56 次）。VII 方法的结果与 80 次吞咽中的 73 次（91.3%）食管造影估计的食团转运模式一致。VII 方法的定量数据与食管造影估计的残余食团体积之间的相关性在两组中均较强，健康志愿者的 Pearson 相关系数为 0.805，症状性患者为 0.730。健康受试者内三个吞咽之间的 VII 组内相关系数为 0.901，患者为 0.705，表明该方法具有适度的可靠性。
与同时进行的食管造影估计的食团体积相比，新开发的 VII 方法是一种可靠的评估食管内残余食团体积的方法。
