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Assessment of esophageal dynamics by radionuclide scintigraphy a potential method for early diagnosis of aperistalsis in patients with Chagas disease

The esophageal transit time of a 99mTc labelled test drink (swallow to arrival at the cardia) — TTE — and the time elapsed from swallow to opening of the cardia — TDAC — were assessed by scintigraphy in 40 healthy volunteers (Group I) and in 106 patients with Chagas disease. The passage of the radioactive liquid through the esophagus and the cardia into the stomach was depicted in 2 sec sequential images. A time/activity curve in the region of the cardia was obtained by a multichannel analyzer, from which the 2 parameters were calculated. In the subjects of group I, TTE was the same as TDAC. The mean value was x = 13.2 sec, the standard deviationδ = 1.35 sec and the variation coeficient 10%. The upper limit for normal values was 15.9 sec (x + 2 δ). Thirty nine (36.8%) patients with Chagas disease presented abnormally high TTE, 6 (5.6%) abnormally high TDAC and in 51.0% of the female patients. Dysphagia and pyrosis were mentioned by 51.1% of the patients with enlarged TTE and/or TDAC but only by 24.6% of those with normal times. The assessment of TTE and TDAC by scintigraphic technique is proposed as a screening test for early recognition of esophageal motor disorders as well as for follow-up studies after treatment.


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