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Review
. 2006 May 14;12(18):2818-24.
doi: 10.3748/wjg.v12.i18.2818.

Functional oesophago-gastric junction imaging

Barry P McMahon  1 , Asbjørn M Drewes, Hans Gregersen
Affiliations
Review

Functional oesophago-gastric junction imaging

Barry P McMahon et al. World J Gastroenterol. .

Abstract

Despite its role in disease there is still no definitive method to assess oesophago-gastric junction competence (OGJ). Traditionally the OGJ has been assessed using manometry with lower oesophageal sphincter pressure as the indicator. More recently this has been shown not to be a very reliable marker of sphincter function and competence against reflux. Disorders such as gastro-oesophageal reflux disease and to a lesser extend achalasia still effects a significant number of patients. This review looks at using a new technique known as impedance planimetry to profile the geometry and pressure in the OGJ during distension of a bag. The data gathered can be reconstructed into a dynamic representation of OGJ action. This has been shown to provide a useful representation of the OGJ and to show changes to the competence of the OGJ in terms of compliance and distensibility as a result of endoluminal therapy.

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Figures

Figure 1
Figure 1
Sketch of a conventional impedance planimetry probe with a single set of excitation (E) and sensing (S) electrodes for the measurement of cross-sectional area in the middle of the bag. D is the distance between the sensing electrodes.
Figure 2
Figure 2
Diagram showing multi-electrode probe by Andersen et al for measuring 5 CSAs in the porcine rectum.
Figure 3
Figure 3
Plot showing the changes in the CSAs at the proximal (P), middle (M) and distal (D) electrode pairs as the balloon is distended at a constant flow rate indicated by the increase in volume.
Figure 4
Figure 4
An example of how a probe which can measure 8 CSAs could profile the geometry of the narrowing region of a bodily sphincter.
Figure 5
Figure 5
Plot showing changes in the 8 measured CSAs during bag distension at 40 mL/min. CSA1 is the most distal and CSA8 is the most proximal.
Figure 6
Figure 6
Three dimensional reconstruction of the OGJ geometry in a human volunteer after distension in to a volume of 40 mL. All dimensions are in millimeters. Colour change is indicating increased radius.
Figure 7
Figure 7
Geometric profile of the porcine OGJ before and after the placement of 3 sutures in the OGJ. T indicates the point where wall tension was measured.
See this image and copyright information in PMC

References

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