CLINICAL-VALUE OF THE ESOPHAGEAL SCINTIGR APHY IN MULTI-SWALLOW TECHNIQUE COMPARING TO ESOPHAGEAL MANOMETRY

Diagnosis of esophageal motility disorders is difficult due to the lar ge physiologic variability of bolus transport. With the help of a para metric multiple swallow technique (introduced by Tatsch), using ''cond ensed images'' of each single swallow action before creating a ''mean image'' of six swallows, this problem can be solved. For testing this relatively new method, 12 patients underwent 16 pairs of parametric es ophageal scintigraphy and esophageal manometry. This collective of pat ients consisted of 4 with achalasia and secondary hypomobility of the tubular esophagus, 7 with unspecific esophageal dysfunction confirmed by manometry and 1 with clinical dysphagia and normal status in manome try. Fourteen of 15 pathological manometric findings could be confirme d with parametric scintigraphy. Esophageal manometry was false negativ e in one case and esophageal scintigraphy in another one case. The cal culated emptying rates 10 and 12 s after beginning of swallowing are ( mean+/-SD) 56+/-34% and 60+/-34% respectively for solid meal and 54+-2 5% 57+/-22% respectively for liquid meal. Of 60 emptying rates, 48 are in the pathologic range of less than 80%. As expected, no significant difference was found between emptying rates after 10 and 12 s (two-ta iled matched pairs t-test, 5% significance level). In conclusion, para metric esophageal multiple swallow scintigraphy has been proven to be a non-invasive and sensitive tool for pre- and posttherapeutic care of patients with esophageal motility disorders. It should be mentioned t hat esophageal scintigraphy can give additional information in some ca ses of normal esophageal manometry.