Transcutaneous cervical esophagus ultrasound in adults: Relation with ambulatory 24-h pH-monitoring and esophageal manometry

doi:10.3748/wjg.v13.i39.5245

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Oct 21, 2007 (publication date) through Apr 18, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Clinical Research

World J Gastroenterol. Oct 21, 2007; 13(39): 5245-5252
Published online Oct 21, 2007. doi: 10.3748/wjg.v13.i39.5245

Table 1 Demographic and TCEUS findings in groups divided according to pH monitoring (mean ± SD)

	Group A (n = 20)	Group B (n = 6)	Group C (n = 6)	Group D (n = 8)	Group E (n = 13)	Group F (n = 5)	Group B + D (n = 14)	Group E + F (n = 18)	Group A + F (n = 25)	P
Age (yr)	43.4 ± 12.0	40.0 ± 11.4	47.8 ± 12.7	42.6 ± 12.5	43.17 ± 9.6	37.2 ± 18.8	41.5 ± 11.7	40.5 ± 10.7	42.3 ± 13.7	NS
	(24-72)	(24-58)	(38-72)	(25-62)	(25-65)	(15-64)	(24-629	(16-65)	(15-72)
Sex (F/M)	8/12	3/3	1/5	4/4	11/2	5/0	7/7	2/16	12/13	NS
n (%)	(40/60)	(50/50)	(16.7/83.3)	(50/50)	(84.6/5.4)	(100/0)	(50/50)	(88.9/11.1)	(52/48)
BMI (kg/m²)	27.4 ± 4.5	27.4 ± 4.4	27.4 ± 4.4	27.9 ± 5.6	27.7 ± 4.6	24.9 ± 2.1	27.7 ± 4.9	26.9 ± 4.24	26.9 ± 4.3	NS
	(19.6-37.4)	(19.6-32)	(19.6-32)	(20.6-37.5)	(17.6 ± 35.0)	(22.7-27.4)	(19.6-37.4)	(17.6-35.0)	(19.6-37.5)
ED (mm)	9.4 ± 1.4	9.7 ± 0.9	9.1 ± 1.6	9.6 ± 1.71	8.54 ± 1.82	10.6 ± 1.3	9.6 ± 1.4	9.1 ± 1.9	9.7 ± 1.5	NS
	(6.1-12.1)	(8.2-10.8)	(8.0-12.0)	(6.1-11.4)	(5.5-11.1)	(8.8-12.4)	(6.2-11.4)	(5.5-12.4)	(6.1-12.4)
ELD (mm)	5.0 ± 1.2	5.1 ± 1.1	4.6 ± 1.6	5.2 ± 1.18	3.9 ± 1.4	5.3 ± 1.7	5.16 ± 1.10	4.3 ± 1.6	5.0 ± 1.3	0.023^a
	(3.0-7.7)	(3.00-6.00)	(3.4-7.7)	(3.0-6.4)	(1.5-6.2)	(3.4-7.9)	(3.0-6.4)	(1.5-7.9)	(3.0-7.9)
Esophageal	2.2 ± 0.2	2.3 ± 1.2	2.2 ± 0.1	2.1 ± 0.3	2.3 ± 0.3	2.6 ± 0.7	2.2 ± 0.3	2.4 ± 0.50	2.3 ± 0.4	NS
WT (mm)	(1.5-2.6)	(2.2-2.6)	(2.0-2.3)	(1.5-2.5)	(2.0-3.3)	(2.2-4.0)	(1.6-2.6)	(2.0-4.0)	(1.6-4.0)
DeMeester	19.5 ± 12.1	7.9 ± 3.1	24.3 ± 14.4	24.5 ± 9.1	6.4 ± 4.7	7.5 ± 4.9	17.4 ± 10.9	6.7 ± 4.7	17.7 ± 11.8	NS
score	(1.7-46.2)	(4.6-13.2)	(1.7-46.2)	(14.4-38.9)	(0.8-14.7)	(1.4-17.3)	(4.6-38.9)	(0.8-14.7)	(1.4-46.2)

TCEUS: Transcutaneous cervical esophagus ultrasonography; ED: Esophageal diameter; ELD: Esophageal luminal diameter; Esophageal WT: Esophageal wall thickness; BMI: Body mass index.

^aP < 0.05 between group A + F and group E. NS: Non-significant.

Table 2 Demographic and TCEUS findings of the groups divided according to esophageal manometry (mean ± SD)

	Normal (n = 24)	IEM (n = 5)	Hypo LES (n = 7)	Hyper LES (n = 2)	Total patients (n = 38)	P
Age (yr)	40.1 ± 11.4 (15-64)	50.6 ± 11.9 (39-65)	48.9 ± 11.3 (38-72)	29.0 ± 4.3 (26-32)	42.5 ± 12.2 (15.0-72.0)	NS
Sex (F/M), n (%)	8/16 (66.7%/33.3%)	4/1 (80%/20%)	2/5 (28.6%/71.4%)	2/0 (100%/0%)	24/14 (63.2%/36.8%)	NS
BMI (kg/m²)	26.7 ± 4.6 (17.6-375)	26.7 ± 4.1 (20.6-31.1)	29.58 ± 3.93 (23.1-35.0)	25.4 ± 2.7 (23.4-27.3)	27.2 ± 4.3 (17.6-37.4)	NS
ED (mm)	9.1 ± 1.59 (6.0-12.4)	9.5 ± 2.3 (5.5-11.4)	9.8 ± 1.7 (7.5-12.1)	9.6 ± 1.1 (8.9-10.4)	9.3 ± 1.7 (5.5-12.4)	NS
ELD (mm)	4.5 ± 1.3 (2.0-7.9)	4.7 ± 1.9 (1.5-6.4)	5.1 ± 1.7 (3.1-7.7)	4.7 ± 0.9 (4.1-5.4)	4.68 ± 1.43 (1.5-7.9)	NS
Esophageal WT (mm)	2.2 ± 0.4 (1.6-4.0)	2.4 ± 2.2 (2.0-2.6)	2.3 ± 0.4 (2.0-3.3)	2.35 ± 0.2 (2.2-2.5)	2.3 ± 0.4 (1.6-4.0)	NS

IEM: Ineffective esophageal motility; Hypo LES: Hypotensive lower esophageal sphincter; Hyper LES: Hypertensive lower esophageal sphincter; ED: Esophageal diameter; ELD: Esophageal luminal diameter; Esophageal WT: Esophageal wall thickness; BMI: body mass index. NS: Non-significant.

Table 3 Symptoms of patients according to esophageal monitoring n (%)

	Group A (n = 20)	Group E (n = 13)	Group B + D (n = 14)	Group E + F (n = 18)
Extra-esophageal symptom	12 (60.0)	7 (53.8)	9 (64.3)	12 (66.6)
Cough	6 (30.0)	6 (46.2)	4 (28.5)	8 (44.4)
Hoarseness	5 (25)	3 (23.1)	4 (28.6)	4 (22.2)
Nocturnal wake-up with reflux	10 (50)	5 (38.5)	8 (57.1)	9 (50.0)
Typical symptom	20 (100)	12 (92.3)	14 (100.0)	17 (94.4)
Heartburn	18 (90)	12 (92.3)	12 (85.7)	17 (94.4)
Regurgitation	15 (75)	10 (76.9)	12 (85.7)	13 (72.2)

Table 4 Distribution of patients according to 24-h pH monitoring and manometric findings n (%)

	Manometric findings (abnormal)	Manometric findings (normal)
24-h pH monitoring (Acid reflux)	7 (18.4)	13 (34.3)
24-h pH monitoring (No acid reflux)	7 (18.4)	11 (28.9)

Table 5 24-h pH monitoring and esophageal manometry results

24-h pH monitoring	IEM (n = 5)	Hypo LES (n = 7)	Hyper LES (n = 2)	Normal manometry (n = 24)
PR + DR	2	2		4
PR				6
DR		3		3
Reflux negatives	3	2	1	7
HSE			1	4

IEM: Ineffective esophageal motility; Hypo LES: Hypotensive lower esophageal sphincter; Hyper LES: Hypertensive lower esophageal sphincter ; PR: Proximal reflux; DR: Distal reflux; HSE: Hypersensitive esophagus.

Table 6 Cut-off values for esophageal luminal diameter (ELD) to determine acid reflux

Between groups	Cut off (mm)	AUC	P	Sensitivity (%)	Specificity (%)
Group B + D (total PR) (n = 14)/Group E (reflux negative) (n = 13)	4.83	0.775	0.015^a	79	61
Group B + D (total PR) (n = 14)/Group E + F (reflux negative with HSE) (n = 18)	4.95	0.708	0.046	71	77
Group A (n = 20)/Group E (reflux negative) (n = 13)	4.95	0.721	0.034	60	77

HSE: Hypersensitive esophagus; PR: Proximal reflux; AUC: Area under the curve. P values show significance of AUC (^aP < 0.05).

Citation: Kacar S, Uysal S, Kuran S, Dagli U, Ozin Y, Karabulut E, Sasmaz N. Transcutaneous cervical esophagus ultrasound in adults: Relation with ambulatory 24-h pH-monitoring and esophageal manometry. World J Gastroenterol 2007; 13(39): 5245-5252
URL: https://www.wjgnet.com/1007-9327/full/v13/i39/5245.htm
DOI: https://dx.doi.org/10.3748/wjg.v13.i39.5245