Evaluation of functional esophageal dismotility by high-frequency intraluminal ultrasonography in patients with gastroesophageal reflux / 中华超声影像学杂志

ABSTRACT

Objective To investigate the functional esophageal dismotility in patients with gastroesophageal reflux disease(GERD) by simultaneous high frequency intraluminal ultrasonography(HFIUS) and esophageal manometry,and evaluate the correlation between the peak pressure and the peak muscle thickness of the esophagus.Besides,to identify the potential efficacy and feasibility of the HFIUS for evaluating the functional gastrointestinal diseases(FGIDs).Methods Ten GERD patients and 5 healthy controls were enrolled into this study.High-frequency ultrasonic probe and esophageal manometry catheter were simultaneous administrated.The cross sectional image of esophageal motion was recorded by HFIUS and was analyzed by the contractility index (CI)of the longitudinal smooth muscle(LSM)and circular smooth muscle(CSM),the duration of the contraction (DC)and the maximum cross section area(CSA)during distension;In addition,esophageal peak pressure during wet-swaltow was measured by manometry.Results Tile contractility index of the LSM and CSM of esophagus at 5 cm,10 cm,1 5 cm and 20 em proximal to the LES was significantly lower in patients with GERD than that of controls(P＜0.05).The duration of the contraction was longer in patients with GERD.But there was no siginificant difference of the maximum CSA during distension between GERD patients and normal controls(P＞0.05).However,the simultaneous manometry only demonstrated nonspecific esophageal motility disorder on 6 of 10 GERD patients.And there was positive correlation between the peak pressure and the peak muscle thickness at all sites along the axis of the esophagus,revealed the pressure was increasing along with the thickening of the esophageal muscle layers(r=0.552-0.736).Conclusions Functional esophageal dismotility played an important role in the pathogenesis of GERD.Meanwhile,there was positive correlation between the esophageal pressure and the muscle layer thickness of the esophagus.HFIUS can detect the minor changes of the layer structure of the esophagus and is a potentially useful imaging modality for evaluating esophageal dismotility as well as FGIDs.