Chulalongkorn Medical Journal


Background : Esophageal scintigraphy is a non-invasive tool for detection ofesophageal functional abnormality. But the lack of standardizedprocedure results in a wide range of reported sensitivity andspecificity. Concerning the method of data acquisition, somestudies found from their data that several swallowing provide abetter result than single swallowing technique.Objective : To compare the accuracy of single swallowing and multipleswallowing methods in detection of esophageal functionalabnormality using manometry as gold standard.Methods and Materials : Thirty-six patients who were clinically suspected of esophagealmotility abnormality were examined using six consecutiveswallows of the radiolabeled liquid and semisolid bolus. Sixparameters were calculated for each swallowing technique.The first was used to calculate single swallowing parameters.Averages of six swallowing parameters were used as multipleswallowingparameters. All patients were investigated withmanometry for their final diagnosis.Results : Twenty-eight patients had abnormal manometry results. Multipleliquid swallows provided the best diagnostic accuracy; allparameters, except mean time, had area under ROC curves ofmore than 0.85. The mean transit time of 8.8 sec. and emptyingof 82% using multiple liquid swallows resulted in the bestsensitivity (96%). The semisolid swallowing gave variable results;2 parameters were better for multiple-swallowing technique, theother 4 parameters were better for single-swallowing technique.Conclusion : Multiple liquid swallowing technique provides best diagnosticaccuracy in detection of esophageal functional abnormality. Theresults of semisolid swallowing varied, probably because it wasdifficult to standardize the consistency of semisolid bolus.


Faculty of Medicine, Chulalongkorn University

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