Transnasal US of the esophagus: preliminary morphologic and function studies.

Liu, Ji‐Bin; Miller, Larry S.; Goldberg, Barry B.; Feld, Rick I.; Alexander, Archie A.; Needleman, Laurence; Do, Castell; Klenn, Philip J.; Millward, Carl

doi:10.1148/radiology.184.3.1509056

Cited by 79 publications

(47 citation statements)

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“…Nicosia et al [1] , using the data of Miller et al [4] , and Dai et al [2] used a custom assembly that combined highfrequency ultrasound with water-perfused manometry to collect esophageal segment cross-sectional images simultaneously with intraluminal pressure. A 20 MHz ultrasonographic transducer, placed within a 6 French catheter, rotated at 15-30 Hz to provide 360 degrees esophageal cross-sectional imaging with a 0.1 mm axial slice thickness and a typical penetration depth of 2 cm was used.…”

Section: Figurementioning

confidence: 99%

“…Miller et al [4] were the first to report measurements of muscle thickness concurrent with intraluminal pressure during esophageal bolus transport. They report results essentially equivalent to the thickness and pressure results in Figure 8, showing an increase and decrease in muscle thickness surrounding the pressure as in Figure 8.…”

Section: Related Observationsmentioning

confidence: 99%

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Function of longitudinal бvs�� circular muscle fibers in esophageal peristalsis, deduced with mathematical modeling

Brasseur

Nicosia²,

Pal³

et al. 2007

WJG

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Section: Figurementioning

confidence: 99%

Section: Related Observationsmentioning

confidence: 99%

Function of longitudinal бvs�� circular muscle fibers in esophageal peristalsis, deduced with mathematical modeling

Brasseur

Nicosia²,

Pal³

et al. 2007

WJG

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“…A NUMBER OF INVESTIGATORS have reported the use of highfrequency intraluminal ultrasound (HFIUS) to measure esophageal contractility (10,11,15,22,25). Increase in the thickness of circular and longitudinal muscle during esophageal contraction is temporally related with the increase of intraluminal pressure.…”

mentioning

confidence: 99%

Relationship between esophageal muscle thickness and intraluminal pressure in patients with esophageal spasm

Pehlivanov

Liu

Kassab

et al. 2002

American Journal of Physiology-Gastrointestinal and Liver Physi

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. Relationship between esophageal muscle thickness and intraluminal pressure in patients with esophageal spasm. Am J Physiol Gastrointest Liver Physiol 282: G1016-G1023, 2002 10.1152/ ajpgi.00365.2001.-We previously showed, in normal subjects, a positive correlation between the esophageal contraction amplitude and peak muscle thickness. The goal of this study was to determine the relationship between esophageal muscle thickness and contraction amplitude in patients with highamplitude peristaltic and simultaneous contractions. Eleven patients with high-amplitude peristaltic contractions, 8 with diffuse esophageal spasm (DES), 7 with nonspecific (NS) motor disorder of the esophagus, and 10 normal subjects were studied using simultaneous pressure and ultrasound imaging. Pressure was recorded by manometry and ultrasound imaging with a high-frequency ultrasound probe catheter. Recordings were performed in the lower esophageal sphincter (LES) and at 2, 4, 6, 8, and 10 cm above the LES during resting state and swallow-induced contractions. Baseline esophageal muscle was thicker in the distal, compared with the proximal esophagus both in normal subjects and patient groups. Patients with DES and nutcracker esophagus (NC) have a higher baseline muscle thickness compared with normal and NS patients. Correlation between the peak pressure and the peak muscle thickness was weaker in patients with NC and DES compared with normal subjects and patients with NS. Whereas normal subjects have good correlation between delta (difference between peak and baseline) muscle thickness and peak pressures, this relationship was absent in patients with NC and DES. Increase in contraction amplitude in patients with NC and DES was associated with an increase in baseline thickness of esophageal muscularis propria. Increase in baseline thickness was specific to patients with spastic motor disorders and was not seen in patients with NS.

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“…A manometric catheter (4.4-mm diameter) was included to make the model relevant to the in vivo motility studies from which the data were obtained. This also removes a concern about the effect of folding of the mucosal lining, largely absent with a catheter of this diameter (32,36,59). …”

Section: The Anatomical Modelmentioning

confidence: 99%

Liquid in the gastroesophageal segment promotes reflux, but compliance does not: a mathematical modeling study

Ghosh¹,

Kahrilas

Brasseur³

2008

American Journal of Physiology-Gastrointestinal and Liver Physi

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Ghosh SK, Kahrilas PJ, Brasseur JG. Liquid in the gastroesophageal segment promotes reflux, but compliance does not: a mathematical modeling study. Am J Physiol Gastrointest Liver Physiol 295: G920 -G933, 2008. First published August 21, 2008 doi:10.1152/ajpgi.90310.2008.-The mechanical force relationships that distinguish normal from chronic reflux at sphincter opening are poorly understood and difficult to measure in vivo. Our aim was to apply physics-based computer simulations to determine mechanical pathogenesis of gastroesophageal reflux. A mathematical model of the gastroesophageal segment (GES) was developed, incorporating the primary anatomical and physiomechanical elements that drive GES opening and reflux. In vivo data were used to quantify muscle stiffness, sphincter tone, and gastric pressure. The liquid lining the mucosa was modeled as an "effective liquid film" between the mucosa and a manometric catheter. Newton's second law was solved mathematically, and the space-time details of opening and reflux were predicted for systematic variations in gastric pressure increase, film thickness, muscle stiffness, and tone. "Reflux" was defined as "2 ml of refluxate entering the esophagus within 1 s." GES opening and reflux were different events. Both were sensitive to changes in gastric pressure and sphincter tone. Reflux initiation was extremely sensitive to the liquid film thickness; the protective function of the sphincter was destroyed with only 0.4 mm of liquid in the GES. Compliance had no effect on reflux initiation, but affected reflux volume. The presence of abnormal levels of liquid within the collapsed GES can greatly increase the probability for reflux, suggesting a mechanical mechanism that may differentiate normal reflux from gastroesophageal reflux disease. Compliance does not affect the probability for reflux, but affects reflux volume once it occurs. Opening without reflux suggests the existence of "gastroesophageal pooling" in the distal esophagus, with clinical implications. gastroesophageal reflux disease; lower esophageal sphincter; compliance; stiffness MUCH IS UNDERSTOOD ABOUT THE biomechanics underlying gastroesophageal reflux once refluxate flow into the esophagus has occurred, such as sphincter relaxation pressures (21), transsphincteric pressure gradient (46), hiatal distension (25), and the proximal extent of reflux (11). However, the mechanical differences that distinguish normal from chronic reflux are those that manifest at the time of opening and the initiation of reflux; these are less well understood. This lack of understanding of the initiation process is primarily because the initial opening process involves a level of mechanical subtlety in the balances among multiple forces and muscle deformations that are difficult to measure accurately in vivo due to rapid changes occurring over very short times with small changes in radial distention.The opening of the gastroesophageal segment (GES) and reflux result from dynamic adjustments in the subtle force balance that are initi...

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Transnasal US of the esophagus: preliminary morphologic and function studies.

Cited by 79 publications

References 0 publications

Function of longitudinal бvs�� circular muscle fibers in esophageal peristalsis, deduced with mathematical modeling

Function of longitudinal бvs�� circular muscle fibers in esophageal peristalsis, deduced with mathematical modeling

Relationship between esophageal muscle thickness and intraluminal pressure in patients with esophageal spasm

Liquid in the gastroesophageal segment promotes reflux, but compliance does not: a mathematical modeling study

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