Sellar R J, De Caestecker J S, Heading R C
Clin Radiol. 1987 May;38(3):303-7. doi: 10.1016/s0009-9260(87)80077-6.
Fifty patients, 19 with heartburn and 31 with noncardiac chest pain were studied using radiology, endoscopy and 24h ambulatory intraoesophageal pH monitoring. Barium radiology was performed using a 'physiological' method and a 'compression' method to induce reflux. Double contrast oesophograms were also obtained. Thirty-four patients had significant acid reflux detected by a pH probe. Using this as a standard, the 'physiological' method detected 17, the 'compression' method 24 and endoscopy 17 patients with reflux, with two, four and one false positives respectively. Compression barium was the most sensitive (71%) and accurate (72%), while endoscopy was the most specific (94%) but least accurate (64%) in detecting patients with acid reflux. Using a double contrast barium technique, measurement of the internal diameter of the cardiac oesophagus (more than 25 mm abnormal) had a sensitivity of 74%, specificity 86% and accuracy 78% in detecting patients with acid reflux. When the results of the compression method and measurement of internal diameter were combined, sensitivity was 87%, specificity 69% and accuracy 81%. These results suggest that, by combining a test to provoke reflux with a double-contrast technique to measure the internal diameter of the cardiac oesophagus, barium radiology becomes a sensitive screening test for reflux.
对50名患者进行了研究，其中19名有烧心症状，31名有非心源性胸痛，采用了放射学、内窥镜检查和24小时动态食管内pH监测。使用“生理性”方法和“压迫”方法进行钡剂放射学检查以诱发反流。还获得了双重对比食管造影。通过pH探头检测发现34名患者有明显的酸反流。以此为标准，“生理性”方法检测出17名有反流的患者，“压迫”方法检测出24名，内窥镜检查检测出17名，分别有2例、4例和1例假阳性。压迫钡剂检查在检测酸反流患者方面最敏感（71%）且最准确（72%），而内窥镜检查特异性最高（94%）但准确性最低（64%）。使用双重对比钡剂技术，测量贲门食管内径（超过25mm为异常）在检测酸反流患者方面敏感性为74%，特异性为86%，准确性为78%。当将压迫法结果与内径测量结果相结合时，敏感性为87%，特异性为69%，准确性为81%。这些结果表明，通过将诱发反流的试验与测量贲门食管内径的双重对比技术相结合，钡剂放射学成为一种敏感的反流筛查试验。
