Cervical esophageal motility: evaluation with US in progressive systemic sclerosis

Area of Science:

• Gastroenterology
• Medical Imaging
• Rheumatology

Background:

• Progressive systemic sclerosis (PSS) frequently involves esophageal dysmotility.
• Accurate assessment of esophageal motility, particularly in the cervical region, is crucial for understanding PSS progression and symptoms.
• Conventional methods for esophageal motility assessment have limitations.

Purpose of the Study:

• To evaluate the utility of high-resolution ultrasound (US) in assessing cervical esophageal motility.
• To compare US findings with manometric and radionuclide esophageal scintigraphic (RES) criteria in healthy volunteers and PSS patients.

Main Methods:

• High-resolution ultrasound (US) was used to visualize the propulsion of ingested soda.
• Twenty healthy volunteers with normal manometric and RES criteria were studied.
• Twenty-eight patients with PSS were classified into three groups based on RES findings: normal motility, hypomotility excluding cervical esophagus, and hypomotility of the cervical esophagus.

Main Results:

• In healthy volunteers, US showed smooth and rapid soda propulsion.
• In PSS patients, US revealed abnormal peristalsis (slow, to-and-fro motion, low velocities) in the cervical esophagus in a subset of patients.
• Soda retention in the cervical esophagus was observed, not exclusively limited to patients with confirmed cervical hypomotility.

Conclusions:

• High-resolution ultrasound (US) is a valuable tool for evaluating cervical esophageal motility.
• US can detect abnormalities in peristalsis and propulsion in patients with progressive systemic sclerosis.
• US offers a non-invasive method for assessing esophageal function in the context of systemic sclerosis.