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Departments of 1 Medicine,
2 Gastrointestinal Medicine, and
5 Radiology,
There is currently
no ideal method for concurrently assessing intraluminal pressures and
flows in humans with high temporal resolution. We have developed and
assessed the performance of a novel fiber-optic laser-Doppler
velocimeter, mounted in a multichannel manometric assembly. Velocimeter
recordings were compared with concurrent fluoroscopy and manometry
following 50 barium swallows in healthy subjects. During these
swallows, the velocimeter sensor was situated in either the proximal
(24 swallows) or the distal (26 swallows) esophagus. It signaled
intraluminal flow following 46 of 50 swallows. A greater mean number of
deflections were recorded in the distal compared with the proximal
esophagus (4.3 vs. 2.4, P = 0.001).
The maximal flow velocity recorded did not differ between the proximal
and distal esophagus (76.7 vs. 73.8 mm/s). No velocimeter signals
commenced after fluoroscopic lumen occlusion. The velocimeter signals
were closely temporally related to fluoroscopic barium flow. Upward
catheter movement on swallowing sometimes appeared to cause a
velocimeter signal. Manometrically "normal" swallows were no
different from "abnormal" swallows in the number and velocity of
deflections recorded by the velocimeter. This novel instrument measures
intraluminal flow velocity and pressures concurrently, thus enabling
direct study of pressure-flow relationships. Flow patterns differed
between the proximal and distal esophagus.
intraluminal flow; pressure-flow relationships; laser-Doppler flow measurement
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