Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
Department of Material Science & Engineering, Jacobs School of Engineering, University of California, La Jolla, CA, USA.
Neurogastroenterol Motil. 2021 Jul;33(7):e14071. doi: 10.1111/nmo.14071. Epub 2020 Dec 29.
Intraluminal esophageal impedance (ILEE) has the potential to measure esophageal luminal distension during swallow-induced peristalsis in the esophagus. A potential cause of inaccuracy in the ILEE measurement is the swallow-induced air in the bolus.
Compare a novel gel bolus to the current alternatives for the measurement of impedance-based luminal distension (cross-sectional area, CSA) during primary peristalsis.
12 healthy subjects were studied using high-resolution impedance manometry (HRMZ) and concurrently performed intraluminal ultrasound (US) imaging of the esophagus. Three test bolus materials were used: 1) novel gel, 2) 0.5 N saline, and 3) commercially available Diversatek EFTV viscous. Testing was performed in the supine and Trendelenburg (-15°) positions. US imaging assessed air in the bolus and luminal CSA. The Nadir impedance values were correlated to the US measured CSA. A custom Matlab software was used to assess the bolus travel times and impedance-based luminal CSA.
The novel gel bolus had the least amount of air in the bolus during its passage through the esophagus, as assessed by US image analysis. The novel gel bolus in the supine and Trendelenburg positions had the best linear fit between the US measured CSA and nadir impedance value (R = 0.88 & R = 0.90). The impedance-based calculation of the CSA correlated best with the US measured CSA with the use of the novel gel bolus.
We suggest the use of novel gel to assess distension along with contraction during routine clinical HRM testing.
腔内食管阻抗（ILEE）有可能在食管蠕动性吞咽时测量食管腔内扩张。ILEE 测量的一个潜在误差源是吞咽引起的食团内空气。
比较新型凝胶食团与目前用于测量原发性蠕动期间基于阻抗的管腔扩张（横截面积，CSA）的替代物。
12 名健康受试者接受高分辨率阻抗测压（HRMZ）和食管腔内超声（US）成像检查。使用三种测试食团材料：1）新型凝胶，2）0.5 N 生理盐水，3）市售 Diversatek EFTV 粘性物。测试在仰卧位和头低脚高位（-15°）进行。US 成像评估食团内的空气和管腔 CSA。最低阻抗值与 US 测量的 CSA 相关。使用自定义 Matlab 软件评估食团通过时间和基于阻抗的管腔 CSA。
新型凝胶食团在通过食管时食团内的空气量最少，这通过 US 图像分析评估。在仰卧位和头低脚高位，新型凝胶食团在 US 测量 CSA 和最低阻抗值之间具有最佳线性拟合（R = 0.88 和 R = 0.90）。使用新型凝胶食团时，CSA 的基于阻抗的计算与 US 测量 CSA 相关性最好。
我们建议在常规临床 HRM 测试中使用新型凝胶来评估扩张和收缩。
