Explore The Application Of Oral Contrast-enhanced Tran-sabdominal Ultrasound In The Diagnosis Of Achalasia

Objective:To explore the application of oral contrast-enhanced trans-abdominal ultrasound in the diagnosis of achalasia.To describe the oral contrast-enhanced gastr-ointestinal ultrasound characteristics in patients with achalasia,providing auxiliary diagnosis basis for AC diagnosis and basic data support for follow-up related research.Methods:28 patients diagnosed achalasia with manometry,endoscopy,and barium swallow esophagogram were examined with OCTU.The ultrasound variables includes lower esophagus inner diameter and length,and the esophagogastric junction inner diameter,length,Outer diameter,EGJ muscular thickness,and EGJ opening inner and outer diameters.Then,according to the Eckardt score table,the patients were scored for the four common clinical symptoms,and the scores of the four symptoms were added to the Eckardt total score.At the same ti me,31 healthy volunteers were recruited and examined with OCTU.In order to understand whether the OCTU of AC patients has characteristic manifestations,the ultrasonic variables were compared between the observation group and the control group.Analyzed the correlation among the clinical symptoms,OC TU variables and manometric variables in AC patients.Results:1.No difference between the age and gender distribution of the patient group and the normal group(P>0.05).2.There was a strong correlation among dysphagia,reflux,chest pain and weight loss in the observation group(P<0.01).3.In the observation group,as the duration prolonged,the patient’s dysphagia worsens(r=0.845,P<0.01).The higher the Eckardt score of patients with severe dysphagia symptoms,the easier it was for OCTU to observe significant dilation of the lower esophagus(r=0.859,P<0.01);4.In the observation group,EGJ opening inner diameter was negatively correlated with the four indicators of Eckardt score.The smaller EGJ opening inner diameter,the clinical symptoms of patients are obvious.5.EGJ opening outer diameter and EGJ opening inner diameter in the observation group were lower than the control group,which was statistically significant(P<0.05);EGJ muscular thickness was thicker than that of the control group,which was statistically significant(P= 0.001).6.In the observation group,the lower esophageal sphincter pressure is negatively correlated with the EGJ opening outer diameter and EGJ opening inner diameter(P<0.01).If the lower esophageal sphincter pressure is high,the opening of EGJ was small;EGJ muscular-thickness was positively correlated with the lower esophageal sphincter pressure(P<0.01).7.According to the ROC curve,it is found that Eckardt score is more suitable as an index to predict whether a patient will undergo surgery than OCTU variables and manometric variables.Conclusions:OCTU’s food contrast medium is with good tolerance.By displaying esoph ageal peristalsis and EGJ dynamic open,AC can be diagnosed quickly and reli ably.OCTU has the advantages of non-invasive,non-radiation,simple,repeatab le,and inexpensive.It is an important clinical examination tool for diagnosis o f AC.