2010 Volume 25 Issue 1 Pages 38-43
Objective: In order to discover early esophageal cancer, fine mucosal cancer lesions must be clearly visible and institutions refine the contrast technique in various ways to achieve this. In our clinic, we previously had examinees raise their chins, and administered the contrast medium and air at the same time (hereafter open method) but they often suffered aspiration. Currently, we administer the contrast agent and air in the normal way and achieve double contrast at the optimum time (hereafter non-open method). In this study, we conducted a comparison of the open and non-open methods.
Subjects: The subjects were 573 patients who underwent examination by both the open and non-open methods.
Methods: We scored contrast agent attachment, mucosa visibility, air bubble formation (upper and lower areas) and cardia visibility according to 3 grades: good, acceptable and not acceptable. The maximum overall score was 21 and we made overall evaluations according to the same 3 grades as follows:17-21 good, 12-16 acceptable, 7-11 not acceptable.
Results: Mucosa visibility of the lower esophagus was judged to be unacceptable in significantly less patients in the non-open method group (5 patients, 0.9%) than in the open method group (17 patients, 3%). For air bubble formation, significantly more patients in the non-open group (212, 37%) were evaluated as good than in the open group (165, 28.8%). In the overall image evaluation, the non-open method was also superior, rated as good in 316 patients (55.2%) as opposed to 277 patients (48.3%) in the open method group.
Conclusion: The open method was previously considered to be a good way of enhancing mucosa visibility but the present results showed that the non-open method was superior to it in terms of overall image quality.
