在诊断测试中经常存在差异,以检测与食道下关节相关的阻塞
Chanakyaram A Reddy1, Ashton Ellison1, Daisha J Cipher2
1Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas, USA.
高分辨率测量仪 (HRM),功能性光膜成像探针 (FLIP) 和食道仪之间的差异对于低食道 (LES) 阻塞是常见的. 多模式测试对于准确的诊断和改善患者的治疗结果至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 食道生理学 食道生理学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 低食道 (LES) 阻塞的诊断可能是具有挑战性的.
- 在高分辨率测量仪 (HRM),功能光度成像探针 (FLIP) 和食道图之间经常发生差异.
- 这些差异对临床管理和结果的影响尚不清楚.
研究的目的:
- 确定HRM,FLIP和食道图之间的差异频率,以确定 LES阻塞.
- 评估这些差异如何影响临床治疗和患者的治疗结果.
- 将个别测试的诊断性能与共识意见进行比较.
主要方法:
- 对126名患有食道症状的患者进行了回顾性审查,他们接受了HRM,FLIP,食道图和内镜检查.
- 在三个测试中对LES阻塞识别的差异分析.
- 后勤回归和ROC曲线分析,以评估LES阻塞的预测性能.
主要成果:
- 这三项测试都同意,只有57%的患者出现了SLE阻塞.
- 功能光成像探测器 (FLIP) 显示了 LES 阻塞的最高预测值 (AUC 0.796),其次是 HRM (AUC 0.764).
- 10%的患者因FLIP/食道图发现而改变了治疗方法,而在HRM中没有发现,69%的患者在LES指导干预后出现了症状改善.
结论:
- 高分辨率测量仪,FLIP和食道图在识别LES阻塞方面存在局限性,导致频繁的差异.
- 多模式测试,包括HRM,FLIP和食道图的发现,通常是准确评估SLE相关阻塞的必要条件.
- FLIP似乎是 LES 阻塞的强有力的预测指标,可以指导管理变化,从而改善结果.
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