Diagnosis of Achalasia and Its Related Esophageal Motility Disorders from the Viewpoint of Barium Esophagogram Yoshitaka Hata 1 , Shohei Hamada 1 , Masafumi Wada 1 , Hiroko Ikeda 1 , Keishi Komori 1 , Haruei Ogino 1 , Eikichi Ihara 1 1Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan Keyword: 食道X線造影検査 , 食道運動異常症 , 高解像度食道内圧検査 , シカゴ分類 , 食道アカラシア pp.316-326
Published Date 2020/3/25
DOI https://doi.org/10.11477/mf.1403201979
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 Recently developed HRM(high-resolution manometry)has enabled us to evaluate esophageal motility in detail. As a result of the Chicago classification, EMD(esophageal motility disorders)have been recognized in clinical practice. Although HRM is the gold standard for EMD diagnosis, it is not yet widely used and is available in only few specialized hospitals in Japan. Therefore, BE(barium esophagram)is expected to play a role in screening for EMD before performing HRM. In this study, we aimed to determine the usefulness of BE in EMD diagnosis by focusing on findings, such as rosary beads, corkscrew appearance, wave appearance, or absent peristalsis. Although the findings of BE were insufficient to classify EMD into specific disorders, the sensitivity and specificity of BE for the general diagnosis of EMD was 73.3% and 92.7%, respectively. We conclude that BE could play a significant role in identifying EMD. In addition to these findings, identification of diverticula of the middle or lower esophagus is another important benefit of using BE for EMD screening.

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