Aslan Ekrem, Akbal Erdem
Department of Internal Medicine Sciences, Faculty of Medicine, İstinye University, İstanbul, Turkiye.
Department of Gastroenterology, Liv Hospital Ulus, İstanbul, Turkiye.
Turk J Med Sci. 2025 Jun 2;55(3):743-753. doi: 10.55730/1300-0144.6023. eCollection 2025.
BACKGROUND/AIM: The accuracy of pressure measurements with ManoScan™ high-resolution manometry (HRM) catheters decreases due to the development of pressure drift (PD) resulting from variations between room and body temperature. The corrective algorithm called thermal compensation (TC), added to the manometry software program by the manufacturer is used to prevent the development of PD. To date, no studies have demonstrated that PD leads to changes in manometry metrics and/or clinical diagnosis. The present study aims to demonstrate the impact of the TC algorithm on HRM metrics and final diagnosis.
Records of 124 consecutive esophageal HRM studies with ManoScan™ HRM catheters were retrospectively reviewed. Manometry metrics and final diagnoses were compared by applying formal TC as recommended by the manufacturer (fTC group), without TC (nonTC group), and by performing TC at the 1st s (TC1 group), 5th s (TC5 group), and 10th s (TC10 group), respectively.
Significant differences were observed in values of integrated relaxation pressure (IRP) and distal contractile integral (DCI), and the percentage of weak and intact peristalsis between the fTC group versus the TC1 and TC5 groups. In 28 of 85 studies in which IRP was normal and in 25 of 39 studies in which IRP > 15 mmHg, contrary IRP values were detected when TC was not performed or performed at a different time point than recommended. In the comparison of diagnoses, fewer esophagogastric junction outflow obstruction (EGJ-OO) and more normal esophageal motility (NEM) were diagnosed in the fTC group than in the nonTC group.
The omission of the TC or its application at an incorrect time point on esophageal manometry studies using the ManoScan™ HRM system can lead to inaccurate IRP measurements and diagnostic errors between NEM and EGJ-OO diagnoses.
背景/目的：由于室温和体温差异导致压力漂移（PD）的出现，使用ManoScan™高分辨率测压（HRM）导管进行压力测量的准确性会降低。制造商在测压软件程序中添加的称为热补偿（TC）的校正算法用于防止PD的出现。迄今为止，尚无研究表明PD会导致测压指标和/或临床诊断发生变化。本研究旨在证明TC算法对HRM指标和最终诊断的影响。
回顾性分析了124例连续使用ManoScan™ HRM导管进行食管HRM研究的记录。分别按照制造商推荐应用正式热补偿（fTC组）、不应用热补偿（非TC组）以及在第1秒（TC1组）、第5秒（TC5组）和第10秒（TC10组）进行热补偿，比较测压指标和最终诊断结果。
fTC组与TC1组和TC5组之间，在综合松弛压（IRP）和远端收缩积分（DCI）的值以及弱蠕动和完整蠕动的百分比方面观察到显著差异。在85项IRP正常的研究中有28项，以及在39项IRP>15 mmHg的研究中有25项，当未进行热补偿或在与推荐时间点不同的时间进行热补偿时，检测到相反的IRP值。在诊断比较中，fTC组诊断出的食管胃交界流出道梗阻（EGJ-OO）比非TC组少，正常食管动力（NEM）比非TC组多。
在使用ManoScan™ HRM系统进行食管测压研究时，遗漏热补偿或在错误的时间点应用热补偿会导致IRP测量不准确以及NEM和EGJ-OO诊断之间的诊断错误。
