Dysphagia is a symptom suggestive of severe underlying pathology, although its causes include organic and non-organic disorders. A balance must be struck between the potential complications of any invasive investigation and its diagnostic utility, especially for elderly patients with dysphagia. The aim of this study was to investigate whether transabdominal ultrasonography (TUS) can differentiate among patients complaining of esophageal dysphagia including achalasia, distal esophageal spasms (DES), neoplasms involving the esophagogastric junction (EGJ) and healthy controls. Methods All patients complained of esophageal dysphagia, while healthy controls had no symptoms originating from esophagus. TUS was performed in 50 patients with achalasia, 17 DES patients, 10 patients with neoplasms, and 39 sex- and age-matched controls. All studies were performed with a 3.5 MHz real time curved array scanner and using an electronic caliper to measure esophageal wall thickness and the maximum esophageal diameter at 3 cm from EGJ. Manometric diagnoses were made based on the Chicago classification ver.3. The cutoff value of each TUS parameter was then calculated. Specificity and sensitivity in making a diagnosis of each disease were determined. Results There were significantly differences in the TUS parameters among four groups (Fig). The cutoff value of diameter of esophageal lumen to differentiate achalasia from other 3 groups was calculated as 13.1 mm (sensitivity, 0.96; specificity, 0.93), with an area under the curve (AUC) of 0.99, and that of esophageal wall thickness to differentiate both the tumor and DES groups from the other two groups was 3.5 mm (sensitivity, 0.64; specificity, 0.62), respectively. Using these parameters, sensitivity and specificity of diagnosis was 0.56 and 0.95 in achalasia, 1.00 and 0.24 in DES, and 1.00 and 0.21 in tumors. Conclusion TUS is a useful, non-invasive diagnostic aid in differentiating patients with primary achalasia from those with other causes of dysphagia.

中文翻译：

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149 主诉食管吞咽困难患者的经腹超声参数差异

吞咽困难是一种提示严重潜在病理的症状，尽管其原因包括器质性和非器质性疾病。必须在任何侵入性检查的潜在并发症及其诊断效用之间取得平衡，尤其是对于吞咽困难的老年患者。本研究的目的是调查经腹超声 (TUS) 是否可以区分主诉食管吞咽困难的患者，包括贲门失弛缓症、食管远端痉挛 (DES)、食管胃交界处肿瘤 (EGJ) 和健康对照组。方法 所有患者均主诉食管吞咽困难，而健康对照组无食管源性症状。对 50 名贲门失弛缓症患者、17 名 DES 患者、10 名肿瘤患者和 39 名性别和年龄匹配的对照组进行了 TUS。所有研究均使用 3.5 MHz 实时弯曲阵列扫描仪并使用电子卡尺测量食管壁厚度和距离 EGJ 3 cm 处的最大食管直径。测压诊断是根据芝加哥分类第 3 版进行的。然后计算每个 TUS 参数的截止值。确定了对每种疾病进行诊断的特异性和敏感性。结果四组TUS参数存在显着差异（图）。食管管腔直径与其他3组鉴别贲门失弛缓症的临界值计算为13.1 mm（敏感性0.96；特异性0.93），曲线下面积（AUC）0.99，食管壁厚鉴别其他两组的肿瘤组和 DES 组均为 3.5 mm（敏感性，0.64；特异性，0.62），分别。使用这些参数，诊断的敏感性和特异性在贲门失弛缓症中为 0.56 和 0.95，在 DES 中为 1.00 和 0.24，在肿瘤中为 1.00 和 0.21。结论 TUS 在区分原发性贲门失弛缓症患者和其他原因吞咽困难患者方面是一种有用的非侵入性诊断辅助手段。