Azienda Sanitaria Provinciale Agrigento - UO Complessa Radiologia Distretto Ag 2 Sciacca Ribera, Presidio Ospedaliero Di Sciacca (AG), Via Pompei, 92019, Sciacca (AG), Italy.
Department of Brain and Behavioral Sciences, University of Pavia, Via Mondino 2, 27100, Pavia, Italy.
Radiol Med. 2023 Jan;128(1):27-34. doi: 10.1007/s11547-022-01581-7. Epub 2022 Dec 24.
Dysphagia is a common symptom in patients with Parkinson's disease (PD), though it may go undiagnosed until severe complications arise. Dysphagia can be suspected on a clinical basis, but an instrumental assessment is mandatory to confirm its presence and evaluate pathophysiological aspects and severity of the swallowing impairment. Aim of this review is to inform the clinician and the radiologist on the importance and the main radiological findings of the Video-Fluoroscopic-Swallow-Study (VFSS) in patients with PD starting from the most recent literature data on the topic.
Databases analysis identified 98 papers (January 2000/October 2022) of which 55 were excluded after reading title, abstract and full-text. After evaluation of the selected articles and their references 7 additional papers were added.
Fifty papers were reviewed to answer the following four main questions: Should VFSS be routinely used to screen dysphagia? Compared to other diagnostic tools, what is the role of VFSS in PD patients with suspected dysphagia? What are the main VFSS findings and technical expedients ? What is the role of VFSS in the choice of the best treatment strategy ?
VFSS represents a gold standard technique in the diagnostic evaluation of dysphagia in PD, having a fundamental role in the identification of patients with high risk of aspiration pneumonia and also being extremely helpful to guide to the choice of treatment strategies for dysphagia.
吞咽困难是帕金森病(PD)患者的常见症状,但直到出现严重并发症才可能被诊断出来。吞咽困难可以通过临床基础来怀疑,但为了确认其存在并评估吞咽障碍的病理生理方面和严重程度,必须进行仪器评估。本文旨在根据该主题的最新文献数据,向临床医生和放射科医生介绍 Video-Fluoroscopic-Swallow-Study(VFSS)在 PD 患者中的重要性和主要放射学发现。
数据库分析确定了 98 篇论文(2000 年 1 月/2022 年 10 月),其中 55 篇在阅读标题、摘要和全文后被排除。在评估所选文章及其参考文献后,又添加了 7 篇论文。
对 50 篇论文进行了回顾,以回答以下四个主要问题:VFSS 是否应常规用于筛查吞咽困难?与其他诊断工具相比,VFSS 在疑似吞咽困难的 PD 患者中的作用是什么?VFSS 的主要发现和技术手段是什么?VFSS 在选择最佳治疗策略中的作用是什么?
VFSS 是 PD 吞咽困难诊断评估的金标准技术,在识别有吸入性肺炎高风险的患者方面具有重要作用,也非常有助于指导吞咽困难治疗策略的选择。