Correlation of manometric and radiographic diagnosis in esophageal motility disorders.

ABSTRACT

BACKGROUND: Radiography and manometry are complementary investigations in the diagnosis of esophageal motility disorders. In most centers, however, manometry is not available and diagnosis is based on radiography alone. AIMS: To correlate the findings on radiography in patients with esophageal motility disorders in whom a manometric diagnosis was available. METHODS: Retrospective analysis of esophageal manometry and barium contrast studies of 138 patients, done for suspected motility disorders, over a period of two years. RESULTS: Manometry was abnormal in 111 (80.4%) cases [achalasia 87, scleroderma 6, non specific esophageal motility disorders (NEMD) 13, diffuse esophageal spasm (DES) 5]. Radiology was abnormal in 106 cases; the overall radiographic sensitivity was 73.9% (achalasia 87.4%, scleroderma 83.3%, NEMD 38.5%) and the positive predictive value was 75.5% (achalasia 95%, scleroderma 100%, NEMD 29.4%). CONCLUSION: Radiography has a high sensitivity and positive predictive value in esophageal motility disorders like achalasia and scleroderma but in DES and NEMD the two investigative modalities (radiography and manometry) do not correlate well.