Radiologia Brasileira - Publicação Científica Oficial do Colégio Brasileiro de Radiologia

AMB - Associação Médica Brasileira CNA - Comissão Nacional de Acreditação
Idioma/Language: Português Inglês

Vol. 40 nº 6 - Nov. / Dec.  of 2007

ICONOGRAPHIC ESSAY
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Page(s) 423 to 427

Esophageal motility: an iconographic essay on dynamic esophageal scintigraphy

Autho(rs): Maria Expósito Penas

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Keywords: Esophageal scintigraphy, Transit time, Motility, Achalasia, Parameters

Descritores: Cintilografia esofagiana, Tempo de trânsito, Motilidade, Acalásia, Parâmetros

Abstract:
This study is an interesting selection of esophageal dynamic images and respective activity/time curves to demonstrate motility ranging from normal to the opposite extreme (advancedstage achalasia). The technique employed was: 4-hour fast, with restriction of smoking, alcohol and caffeine products; anterior 0.5-second imaging during 2 minutes, covering the region from the mouth to the gastric fundus, followed by a planar 20-second image from the same region (normal transit time: < 10 seconds). The collection is based on a twenty-year experience employing a systematization including several parameters, which is able to discriminate patients with normal total esophageal transit time independently of symptoms.

Resumo:
Este trabalho é uma seleção interessante de imagens dinâmicas do esôfago e de curvas de atividade/tempo, variando da motilidade normal até o extremo oposto, a acalásia em estado avançado. A técnica é a usual: quatro horas de jejum, com restrição de fumo, álcool e cafeína; incidência anterior; imagens de 0,5 segundo durante dois minutos, região da boca ao fundo gástrico, seguida de imagem plana de 20 segundos da mesma região (tempo de trânsito normal: < 10 segundos). A coletânea é baseada em vinte anos de experiência empregando uma sistematização com vários parâmetros de análise que permite discriminar pacientes com tempo total de trânsito normal.

 

 

Maria Expósito Penas

PhD, Associate Professor, Department of Radiology - Nuclear Medicine at Faculty of Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil

Mailing address

 

 

INTRODUCTION

The present essay is aimed at showing an interesting selection of images and graphics demonstrating esophageal motility in a spectrum ranging from normal to the opposite extreme that is an advanced-stage achalasia. Besides studies utilizing room-temperature water for radiotracer dilution, further studies (Bernstein tests) were performed with volunteers (with free and informed consent) utilizing mild hydrochloric acid (at 0.1 N and 0.05 N concentration) to reproduce symptoms of gastroesophageal reflux. All of the studies were approached by a standard systematization including the following parameters (for normal values [n]): total esophageal transit time (TETT) (n: < 10.0 s), curve pattern (CP) (n: coordinated), residual activity (RA) (n: < 10%), time for initial entry into stomach (TIES) (n: < 6.0 s), stomach entry form (SEF) (n: abrupt), retrograde movements (RM) (n: absent), curve variation factor (CVF) (n: < 0.1), transit time in the proximal, middle and distal esophageal thirds (PTT, MTT, DTT) (respectively n: < 3.0 s, < 6.0 s and < 10.0 s) and a plain radiographic image of the esophagus (PRI) at the end of the dynamic scintigraphy (n: absent or mild residue)(1-3).

 

REFERENCES

1. Russell COH, Hill LD, Holmes ER III, Hull DA, Gannon R, Pope CE II. Radionuclide transit: a sensitive screening test for esophageal dysfunction. Gastroenterology 1981;80:887–892.         [  ]

2. Blackwell JN, Hannan WJ, Adam RD, Heading RC. Radionuclide transit studies in the detection of oesophageal dysmotility. Gut 1983;24:421–426.         [  ]

3. Penas ME, Orlando MMC, Koch HA. Dynamic esophageal scintigraphy parameters to analyze in single liquid bolus swallow. Alasbimn J 2006; 8(33).        [  ]

 

 

Mailing address:
Profa. Dra. Maria Expósito Penas
Rua Alfredo Corrêa, 150, ap. 204, Ilha do Governador
Rio de Janeiro, RJ, Brazil, 21920-225
E-mail: exposito@hucff.ufrj.br

Received March 8, 2007. Accepted after revision May 8, 2007.

 

 

* Study developed in the Department of Radiology - Nuclear Medicine at Faculty of Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.

 

 

 

 

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