식도운동질환의 방사성 동위원소 식도통과시간 및 통과 양상에 관한 연구

초록

Background/Aims: Radionuclide esophageal transit study (RETS) has been proposed as a screening test for esophageal motility disorders. However, little attention was paid to the esophageal transit patterns in various esophageal motility disorders. In the present study, we have compared the results from esophageal manometry and transit studies. Methods: Ninety six patients with esophageal symptoms and 20 subjects without any known esophageal symptoms or disease were included. The results of RETS were divided into the following 3 patterns: normodynamic (ETT < 15 sec), hypodynamic (15 < ETT < 300 sec). Within the group of patients with the hypodynamic patterns, the transit curves were divided into 3 types: slope type, staircase type and another type. Results: Esophageal transit pattern in normal controls was smooth uninterrupted transit of bolus down the esophagus with mean ETT of 8.5–16.5 seconds. Esophageal transit patterns in patients with esophageal symptoms were adynamic pattern (12 achalasia, 1 scleroderma esophagus, 1 MEMD), normodynamic pattern (19 NEMD), HLES (1 diffuse esophageal spasm nutcracker esophagus), hypodynamic-staircase type (6 diffuse esophageal spasm, 3 NEMD), hypodynamic-slope type (19 NEMD, 3 HLES, 2 normal, 1 diffuse esophageal spasm, 1 nutcracker esophagus) and hypodynamic-other type (5 NEMD, 2 nutcracker esophagus, 1 diffuse esophageal spasm, 1 scleroderma esophagus, 1 normal). Conclusions: Normal subjects exhibited normodynamic patterns, whereas most of the achalasia patterns exhibited adynamic patterns, and patients with diffuse esophageal spasm exhibited various patterns of esophageal transit which suggest that this group has heterogeneous motility abnormalities. (Korean J Gastroenterol 1995;27:499–508)

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