Abstract
Functional magnetic resonance imaging (fMRI) has been recently proposed for the evaluation of the esophagus. Our aim is to assess the role of fMRI as a technique to assess morphological and functional parameters of the esophagus in patients with esophageal motor disorders and in healthy controls. Subsequently, we assessed the diagnostic efficiency of fMRI in comparison to videofluoroscopic and manometric findings in the investigation of patients with esophageal motor disorders. Considering that fMRI was shown to offer valuable information on bolus transit and on the caliber of the esophagus, variations of these two parameters in the different types of esophageal motor alterations have been assessed. fMRI, compared to manometry and videofluoroscopy, showed that a deranged or absent peristalsis is significantly associated with slower transit time and with increased esophageal diameter. Although further studies are needed, fMRI represents a promising noninvasive technique for the integrated functional and morphological evaluation of esophageal motility disorders.
Highlights
The esophageal motility disorders usually present symptoms such as dysphagia or thoracic noncardiac chest pain [1].Esophageal, and since recently high-resolution, manometry is the standard reference to diagnose these disorders by assessing the peristaltic sequences, the lower esophageal sphincter pressure, and its inhibitory reflex
Multichannel intraluminal impedance combined with manometry can offer additional information about bolus transit in the esophageal body but not on esophageal caliber [3]
The esophageal transit time, measured by Functional magnetic resonance imaging (fMRI), increased with the gradual disappearance of peristalsis measured by esophageal manometry
Summary
The esophageal motility disorders usually present symptoms such as dysphagia or thoracic noncardiac chest pain [1].Esophageal, and since recently high-resolution, manometry is the standard reference to diagnose these disorders by assessing the peristaltic sequences, the lower esophageal sphincter pressure, and its inhibitory reflex. Manometry does not give information on the esophageal transit of bolus and is not valuable in case of esophageal dilatation [2]. Even better after swallow dynamic videofluoroscopy (SDV), can assess the transit of the radiopaque bolus along the esophagus and measure the luminal size of the organ. It assesses the after swallow timely opening of the upper and lower sphincters and their coordinated activity with the wall occluding contractions, either simultaneous or propagating along the esophageal body. Multichannel intraluminal impedance combined with manometry can offer additional information about bolus transit in the esophageal body but not on esophageal caliber [3]
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