DIAGNOSTIC CAPABILITIESOF ULTRASONOGRAPHY FOR NON-INVASIVE EVALUATION OF DUODENOGASTRIC REFLUX
Abdullaiev R.Y.1, Bubnov R.V.2, Boyko V.V.2
1Kharkiv Medical Academy of Postgraduate Education, Kharkiv
2Clinical hospital ”Pheophania“, Kyiv
Duodenogastral dismotility is very common in population. Implementation of the simple, safe, noninvasive and reproducible techniques of assessment the duodenogastral reflux is crucial for screening, early diagnosis, staging and continuous evaluation of personalized treatments .
The aim of this study was to evaluate the diagnostic capabilities of ultrasound for non-invasive duodenogastral reflux diagnosis.
Materials and methods.
We enrolled 22 patients with clinical symptoms of duodenogastral reflux disease, the average age of 52 years, had underwent ultrasonography upon empty stomach and after filling by 300 ml of water during 5 minutes. Patients with poor visualtion of duodenum, stomach were excluded. The control group included 20 patients without gastrointestinal symptoms. No obese patients were included. Ultrasonography using convex multifrequency tranceducer 3-5 MHz was carried out. We evaluated: thickness and structure of duodenum, stomach wall, gastroduodenal angle, US gastritis signs, visualizing (anti)peristalsis, detecting Doppler reflux streams frequency per minute, its lenth and width, velocity measurement with followed volume recalculated.
In 21 patients of the first group were revealed US signs of reflux after filling stomach. We evaluated: thickness of duodenum wall as 3.7 mm, stomach wall as 3.3 mm, structure violation was in 5 patients, gastroduodenal angle was 38 ̊, US gastritis signs, visualizing (anti) peristalsis in 16. Doppler reflux streams were detected in 19 patients, mean 2.7 per minute, mean lenth of reflux stream was 38 mm and width 4 mm, the mean velocity was measured as high as 12 cm/sec. The mean duration was 2.2 sec, mean recalculated volume was 3.3 ml. No reflux Doppler streams were registered in controls, mean thickness of duodenum wall was 2.2 mm, stomach wall - 1.8 mm, gastroduodenal angle was 22 ̊, antiperistalsis was visualized in one patient. Difference in mean speed for gastric emptying after filling was not significant in groups.
The sensitivity, specificity and accuracy in ultrasonography diagnostic of duodenogastral reflux disease were 95,4%, 91%, 93,1% respectively (while provided sufficient image quality). Visualizing antiperistalsis, detecting Doppler reflux streams per minute, lenth and width of reflux stream, velocity measurement with recalculated volume are considered as useful diagnostic non-inavsive tool. Additionally evaluated wall structure, thickness of duodenum, stomach wall are helpful for diagnostics.
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