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Radiographic detection of achalasia: diagnostic accuracy of videofluoroscopy
W Schima1, J M Ryan, M Harisinghani
1Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, USA.
Aims:
To retrospectively evaluate the accuracy of videofluoroscopy in the diagnosis of achalasia.
Materials And Methods:
Videofluoroscopic studies of the oesophagus of 53 patients (25 males, 28 females; mean age, 49 years) with manometrically revealed diagnosis of achalasia were retrospectively evaluated. The videofluoroscopic examinations had been carried out with one swallow of low-density barium suspension in the erect and up to three swallows in the prone oblique position. Videofluoroscopically, a diagnosis of achalasia was made in 31 of the patients (58%) with manometrically proven achalasia, of whom only nine had oesophageal dilatation. Non-specific oesophageal motor abnormalities were diagnosed radiographically in 18 patients (34%) and a normal motility in four patients (8%).
Conclusion:
Videofluoroscopy is a valuable and sensitive technique for the detection of disordered oesophageal motility in achalasia.