以「放射核種食道通過」檢查評估進行性全身硬化症病患的食道功能

Radionuclide Esophageal Transit for the Evaluation of Esophageal Function in Patient with Progressive Systemic Sclerosis

放射核種食道通過(radionuclidc esophageal transit)檢查，係以吞嚥含放射性TC-99M sulfur colloid的液製劑，而測其食道內放射性強度改變的方法，來評估食道功能。本院利用此技術，檢查19位進行性全身硬化症病患，發現所有病人均有食道功能不全，其中18位(94.7％)食道活動弛緩(hyponwtility)者中，14位(77. 8％)亦可見食道運動協調不良(incoordination)。另一位則僅有食道運動協調不良，而無活動弛緩。食道活動弛緩，主要發生在食道中、下段平滑肌部位（分別為89.5％及94.7％），但10位(52.6％)上段橫紋肌部也有活動弛緩。19位病患中，13位接受X光食道透視攝影(esophagram)，其中8位(61.5％)可見食道活動弛緩。因此利用放射核種通過檢查，對評估進行性全身硬化症病患食道功能而言，不僅簡單、快速、無傷害性，同時比X光食道透視攝影更為敏感。

Radionuclide esophageal transit (RET) study is a technique for the evaluation of the esophageal function by simply swallowing TC-99M Sulfur colloid liquid agent and then to detect the change of radioactivity in esophagus. The esophageal function of nineteen patients with progressive systemic sclerosis (PSS) were studied by RET. Esophageal dysfunction were found in all 19 patients (100%) and 18 (94.7%) of 19 patients were found to have esophageal hypomotility. Fourteen (77.8%) of the 18 patients with esophageal hypomotility also had esophageal incoordination. Among 19 patients with esophageal dysfunction, one showed esophageal incoordination without esophageal hypomotility. The hypomotility was predominate in the middle and lower one- third of esophagus (89.5% & 94.7% respectively) and less in upper segment (52.6%). In contrast, esophageal hypomotility only was shown in 8 of 13 patients (61.5%) who received the barium esophagogram. RET study is a simple, fast and non- invasive technique and is more sensitive when compared to esophagogram as a tool to detect esophageal involvement in patients with PSS.