Radiology, Vol 185, 487-491, Copyright © 1992 by Radiological Society of North America
Esophageal motor disorders: videofluoroscopic and manometric evaluation- -prospective study in 88 symptomatic patients
W Schima, G Stacher, P Pokieser, K Uranitsch, D Nekahm, E Schober, G Moser and D Tscholakoff
Department of Radiology, University of Vienna, Austria.
Esophageal motor disorders are best evaluated with manometry, which,
however, is time-consuming and not generally available. The authors
prospectively investigated the yield of videofluoroscopy in detection of
esophageal motor disorders in comparison with that of manometry.
Eighty-eight patients with dysphagia, globus sensation, noncardiac chest
pain, or progressive systemic sclerosis underwent both manometry and
videofluoroscopy at 0-32-day intervals. Videofluoroscopy was performed with
one swallowing study in the upright position and up to three swallowing
studies in the prone oblique position. Manometric diagnoses of achalasia (n
= 15), diffuse esophageal spasm (n = 1), nonspecific esophageal motor
disorders (n = 44), and adynamic esophagus (n = 9) were made.
Videofluoroscopically, 87% of the patients with achalasia, the one patient
with diffuse spasms, 73% of the patients with nonspecific esophageal motor
disorders, and all of the patients with adynamic esophagus received a
correct diagnosis, for an overall sensitivity of 80%. The radiographic
specificity was 79%. The authors conclude that videofluoroscopy is a
valuable and reasonably sensitive technique for screening for esophageal
motor disorders.
