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Simultaneous Assessment of Bolus Transport and Contraction Parameters in Multiple-Swallow Investigations

Division of Nuclear Medicine, Department of Radiology and Department of Internal Medicine, University of Munich, FRG

Correspondence: For reprints contact: K. Tatsch, MD, Division of Nuclear Medicine, Department of Radiology, Klinikum Grosshadem, University of Munich, Marchioninistr. 15, 8000 Munich 70, FRG.

ABSTRACT

A better understanding of scintigraphic findings may lead to a wider acceptance of esophageal transit studies. The purpose of this study, therefore, was to correlate standard manometric parameters with the quantitative and qualitative characteristics of liquid and semi-solid bolus transport. Twenty-nine patients were simultaneously investigated with esophageal scintigraphy and manometry. Single-swallow and sum-image data of six consecutive swallows were analyzed. No significant relationship between transit time and the velocity of the peristaltic wave could be identified, which suggests that factors other than peristaltic velocity (e.g., pharyngeal pump) essentially modulate esophageal transit. There was also no linear correlation between esophageal emptying and peristaltic amplitudes. Emptying was normal in patients with amplitudes >30 mmHg and reduced in those with amplitudes <30 mmHg. This suggests that a threshold pressure >30 mmHg is necessary to propel a test bolus adequately. Patterns in condensed images have been shown to specifically reflect the events in corresponding manometric recordings. Normal and different pathologic types of peristalsis presented analogous findings in both modalities. Thus, an analysis of the relationship between bolus transport and contraction parameters in simultaneous studies increases understanding of quantitative and qualitative scintigraphic results.