Eising E G, Holtmann G, Reiners C
Klinik und Poliklinik für Nuklearmedizin, Universität Essen.
Radiologe. 1996 Jun;36(6):508-14. doi: 10.1007/s001170050105.
Diagnosis of esophageal motility disorders is difficult due to the large physiologic variability of bolus transport. With the help of a parametric multiple swallow technique (introduced by Tatsch), using "condensed images" of each single swallow action before creating a "mean image" of six swallows, this problem can be solved. For testing this relatively new method, 12 patients underwent 16 pairs of parametric esophageal scintigraphy and esophageal manometry. This collective of patients consisted of 4 with achalasia and secondary hypomobility of the tubular esophagus, 7 with unspecific esophageal dysfunction confirmed by manometry and 1 with clinical dysphagia and normal status in manometry. Fourteen of 15 pathological manometric findings could be confirmed with parametric scintigraphy. Esophageal manometry was false negative in one case and esophageal scintigraphy in another one case. The calculated emptying rates 10 and 12 s after beginning of swallowing are (mean +/- SD) 56 +/- 34% and 60 +/- 34% respectively for solid meal and 54 +/- 25% 57 +/- 22% respectively for liquid meal. Of 60 emptying rates, 48 are in the pathologic range of less than 80%. As expected, no significant difference was found between emptying rates after 10 and 12 s (two-tailed matched pairs t-test. 5% significance level). In conclusion, parametric esophageal multiple swallow scintigraphy has been proven to be a non-invasive and sensitive tool for pre- and posttherapeutic care of patients with esophageal motility disorders. It should be mentioned that esophageal scintigraphy can give additional information in some cases of normal esophageal manometry.
由于食团运输存在较大的生理变异性，食管运动障碍的诊断较为困难。借助参数化多次吞咽技术（由塔施引入），在创建六次吞咽的“平均图像”之前，使用每次单次吞咽动作的“浓缩图像”，这个问题可以得到解决。为了测试这种相对较新的方法，12名患者接受了16对参数化食管闪烁显像和食管测压。该患者群体包括4例贲门失弛缓症和食管管状部分继发性运动减弱患者、7例经测压证实为非特异性食管功能障碍患者以及1例临床吞咽困难但测压结果正常的患者。15例病理测压结果中有14例可通过参数化闪烁显像得到证实。食管测压有1例假阴性，食管闪烁显像有1例假阴性。吞咽开始后10秒和12秒时计算出的排空率（均值±标准差），固体餐分别为56±34%和60±34%，液体餐分别为54±25%和57±22%。在60个排空率中，48个处于小于80%的病理范围内。正如预期的那样，10秒和12秒后的排空率之间未发现显著差异（双尾配对t检验，显著性水平为5%）。总之，参数化食管多次吞咽闪烁显像已被证明是食管运动障碍患者治疗前和治疗后护理的一种非侵入性且敏感的工具。应该提到的是，在某些食管测压正常的情况下，食管闪烁显像可以提供额外信息。
