Читать книгу The Esophagus - Группа авторов - Страница 213

Esophageal manometry is the primary method to evaluate esophageal motility, done by measuring pressures along the esophagus during test swallows. High‐resolution manometry (HRM) utilizes catheters with pressure sensors spaced 1–2 cm apart spanning from the hypopharynx to the stomach to assess the entire esophagus simultaneously. Sophisticated software algorithms using interpolation between pressure sensors generate esophageal pressure topography (EPT) or Clouse plots that display esophageal motility and sphincter function as color‐coded isobaric contour plots in real time [1, 2]. Analysis of EPT plots is facilitated by analysis software that generates objective metrics of esophageal function that can classify individual swallows and formulate esophageal motility diagnoses [3, 4]. The enhanced pressure resolution, pictorial output, and objective metrics available with HRM/EPT represent a major advancement in technology as compared with the predicate technology in conventional manometry that used pressure sensors spaced 3–5 cm apart displayed as line tracings. As compared with conventional line‐tracing manometry, HRM/EPT provides an increased diagnostic yield for major esophageal motor disorders as well as improved reliability, reproducibility, and accuracy of interpretation [5, 6]. This chapter will discuss the use and interpretation of HRM/EPT.