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First published online August 2, 2006
British Journal of Radiology (2006) 79, 719-724
© 2006 British Institute of Radiology
doi: 10.1259/bjr/17000205
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Full paper

Oesophageal dysmotility in systemic sclerosis: comparison of HRCT and scintigraphy

E H Pitrez, MD1, M Bredemeier, MD, MSc2, R M Xavier, MD, PhD2, K G Capobianco, MD, MSc2, V G Restelli, MD2, M V Vieira, MD, PhD1, D H C Ludwig, MD3, J C T Brenol, MD, PhD2, A P A Furtado, MD1, L M B Fonseca, MD, PhD4 and B Gutfilen, MD, PhD4

1 Serviço de Radiologia, 2 Serviço de Reumatologia, 3 Serviço de Medicina Nuclear, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Porto Alegre, RS, Brazil, 90.035-003, 4 Departamento de Radiologia, Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brigadeiro Trompovsky, Ilha do Fundão, CEP 21941-590, Rio de Janeiro, RJ, Brazil

The aim of this study was to compare oesophageal abnormalities observed in high-resolution CT with radionuclide transit in patients with systemic sclerosis. 76 patients with systemic sclerosis were evaluated by high-resolution CT and oesophageal transit scintigraphy. Residual activity ≥20% (in relation to peak activity) at 15 s after the beginning of the swallow of the labelled liquid (in supine position) was considered indicative of oesophageal dysfunction. Supra-aortic and infra-aortic oesophageal coronal diameters were measured in high-resolution CT. Oesophageal dilatation was deemed present when the diameters exceeded 10 mm. 19 patients (25%) had supra-aortic oesophageal dilatation and 48 patients (63.1%) had infra-aortic dilatation. The prevalence of radionuclide transit delay was 77.6%. All patients (19/19) with supra-aortic dilatation had oesophageal dysfunction, compared with 70.2% (40/57) of the patients with no supra-aortic dilatation (p = 0.004). Oesophageal dysfunction was present in 97.9% (47/48) of patients with infra-aortic dilatation, compared with 42.9% (12/28) in patients without it (p < 0.001). Receiver operating characteristic (ROC) curves have demonstrated that the supra-aortic and infra-aortic diameters had good discriminatory capacity for oesophageal dysfunction in systemic sclerosis (area under the curve, 95% confidence interval: 0.80, 0.70–0.89 and 0.92, 0.86–0.98, respectively). There is a clinically significant association between oesophageal dysmotility and high-resolution CT findings of oesophageal coronal dilatation. The evaluation of infra-aortic oesophageal coronal diameter can provide additional useful information about the functional and anatomic conditions of the oesophagus in systemic sclerosis.




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