The Value of Color Doppler Ultrasonography for a Screening Method of Gastroesophageal Reflux Disease in Children with Chronic Respiratory Symptoms / 소아알레르기및호흡기학회지

ABSTRACT

PURPOSE: The relationship of gastroesophageal reflux(GER) to respiratory diseases has been recognized. Diagnosis of gastroesophageal reflux disease can be confirmed by 24 hour esophageal pH probe study and barium fluoroscopic esophagography. However, for 24 hour esophageal pH monitoring in children, patients should be admitted, and the fluoroscopic studies may have radiation exposure. The objective of this study was to determine the value of color Doppler(CD) ultrasonography as a screening test of gastroesophageal reflux disease in children. METHODS: Thirty-four CD ultrasonographic examinations were performed and compared to simultaneous 24 hour esophageal pH monitoring. The patients were aged 3 months to 10 years, mean age of 36 months. The CD study was performed over a period of 10 minutes after weight-related feeding. The CD ultrasonographic finding was staged in the following way 1) normal 0 reflux, 2) grade I 1-3 refluxes, 3) grade II 3-6 refluxes, and 4) grade III >6 refluxes. RESULTS: Gastroesophageal refluxes were detected in 28 out of 34 patients on CD ultrasonography. Fifteen cases were classified as grade I, 12 cases as grade II, and 1 case as grade III. There was agreement in the diagnosis of reflux or no reflux between pH measurements and CD ultrasonography in 28 out of 34 patients(82%) patients. In the remaining six patients, pH measurements were positive for reflux, and color Doppler ultrasonography showed no reflux in two, while pH-metry were negative and CD showed reflux in four patients. Positive and negative predictive values of CD sonography compared with 24 hour pH monitoring were 85.7% and 66.7% respectively. CONCLUSION: We suggest that CD ultrasonography can be used as a useful and convenient screening method for outpatients suspected of reflux.