Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago.
Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago.
Clin Gastroenterol Hepatol. 2022 Jun;20(6):e1250-e1262. doi: 10.1016/j.cgh.2021.06.040. Epub 2021 Jun 30.
BACKGROUND & AIMS: This study aimed to assess the accuracy of functional luminal imaging probe (FLIP) panometry to detect esophagogastric junction (EGJ) obstruction assigned by high-resolution manometry (HRM) and the Chicago Classification version 4.0 (CCv4.0). METHODS: Six hundred eighty-seven adult patients who completed FLIP and HRM for primary esophageal motility evaluation and 35 asymptomatic volunteers (controls) were included. EGJ opening was evaluated with 16-cm FLIP during sedated endoscopy via EGJ-distensibility index (DI) and maximum EGJ diameter. HRM was classified according to CCv4.0 and focused on studies with a conclusive disorder of EGJ outflow (ie, achalasia subtypes I, II, or III; or EGJ outflow obstruction with abnormal timed barium esophagogram) or normal EGJ outflow. RESULTS: All 35 controls had EGJ-DI >3.0 mm/mmHg and maximum EGJ diameter >16 mm. Per HRM and CCv4.0, 245 patients had a conclusive disorder of EGJ outflow, and 314 patients had normal EGJ outflow. Among the 241 patients with reduced EGJ opening (EGJ-DI <2.0 mm/mmHg and maximum EGJ diameter <12 mm) on FLIP panometry, 86% had a conclusive disorder of EGJ outflow per CCv4.0. Among the 203 patients with normal EGJ opening (EGJ-DI ≥2.0 mm/mmHg and maximum EGJ diameter ≥16 mm) on FLIP panometry, 99% had normal EGJ outflow per CCv4.0. CONCLUSIONS: FLIP panometry accurately identified clinically relevant conclusive EGJ obstruction as defined by CCv4.0 in patients evaluated for esophageal motor disorders. Thus, FLIP panometry is a valuable tool for both independent and complementary evaluation of esophageal motility.
背景与目的:本研究旨在评估功能腔内成像探头(FLIP)测压评估胃食管交界(EGJ)梗阻的准确性,该方法通过高分辨率测压(HRM)和芝加哥分类第四版(CCv4.0)进行评估。
方法:共纳入 687 例接受 FLIP 和 HRM 检查以评估原发性食管动力障碍的成年患者和 35 例无症状志愿者(对照组)。通过 EGJ 可扩张性指数(DI)和最大 EGJ 直径,在镇静状态下经内镜评估 16cm 处 FLIP 时,评估 EGJ 开口。HRM 分类依据 CCv4.0,重点关注 EGJ 流出有明确障碍(即贲门失弛缓症 I、II 或 III 型;或 EGJ 流出梗阻伴异常时间分辨钡餐造影)或 EGJ 流出正常的研究。
结果:所有 35 例对照组的 EGJ-DI>3.0mm/mmHg 和最大 EGJ 直径>16mm。根据 HRM 和 CCv4.0,245 例患者 EGJ 流出有明确障碍,314 例患者 EGJ 流出正常。在 FLIP 测压中 EGJ 开口减小(EGJ-DI<2.0mm/mmHg 和最大 EGJ 直径<12mm)的 241 例患者中,86%根据 CCv4.0 存在明确的 EGJ 流出障碍。在 FLIP 测压中 EGJ 开口正常(EGJ-DI≥2.0mm/mmHg 和最大 EGJ 直径≥16mm)的 203 例患者中,99%根据 CCv4.0 存在正常的 EGJ 流出。
结论:FLIP 测压能够准确识别出由 CCv4.0 定义的、在食管动力障碍评估中具有临床意义的明确 EGJ 梗阻。因此,FLIP 测压是独立评估和补充评估食管动力的有价值的工具。
Clin Gastroenterol Hepatol. 2022-6
Am J Gastroenterol. 2021-12-1
Neurogastroenterol Motil. 2023-11
Aliment Pharmacol Ther. 2025-8
Gastroenterol Hepatol (N Y). 2025-3
Gastroenterology. 2025-7
Clin Gastroenterol Hepatol. 2025-5
Am J Gastroenterol. 2025-5-1
Neurogastroenterol Motil. 2021-9
Neurogastroenterol Motil. 2021-1
Am J Gastroenterol. 2020-11
Clin Gastroenterol Hepatol. 2021-5
Neurogastroenterol Motil. 2020-5
Clin Gastroenterol Hepatol. 2020-9
Clin Gastroenterol Hepatol. 2018-8-3
Gut. 2018-2-3