Esophageal hypomotility in systemic sclerosis: close relationship with pulmonary involvement

Ann Nucl Med. 2001 Apr;15(2):97-101. doi: 10.1007/BF02988598.


Purpose: Esophageal motility was assessed in patients with systemic sclerosis (SSc) by scintigraphy and compared with (i) extent of scleroderma, (ii) duration of disease, (iii) index of anti-topoisomerase I antibody (topo I), and (iv) pulmonary involvement.

Methods: A multiple-swallow test was performed in 47 patients with SSc in the supine position with 99mTc-DTPA. A region of interest on the entire esophagus was defined and the retention ratio (RR) was calculated from a time-activity curve.

Results: Patients with diffuse scleroderma had higher RRs than those with limited scleroderma (48.8% vs. 30.0%; p < 0.05). There was no correlation between the RRs and the duration of disease. Patients with positive topo I had higher RRs than those who were negative (53.8% vs. 29.7%; p < 0.05). Patients with reduced % diffusion capacity for carbon monoxide (%DLCO) had higher RRs than those with normal %DLCO (40.5% vs. 19.6%; p = 0.03). Patients with reduced % vital capacity (%VC) had higher RRs than those with normal %VC (54.6% vs. 25.0%; p < 0.005). Patients with pulmonary fibrosis had higher RRs than those who were negative (58.5% vs. 20.3%; p < 0.00005).

Conclusion: Esophageal dysfunction in patients with SSc showed a correlation with the extent of scleroderma, positive topo I, and pulmonary involvement. The RR can be an objective clinical marker for the severity of organ fibrosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Autoantibodies / blood
  • Case-Control Studies
  • Child
  • DNA Topoisomerases, Type I / immunology
  • Esophageal Motility Disorders / diagnostic imaging*
  • Esophageal Motility Disorders / etiology*
  • Female
  • Humans
  • Lung Diseases / etiology*
  • Lung Diseases / physiopathology
  • Male
  • Middle Aged
  • Pulmonary Diffusing Capacity
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Scleroderma, Systemic / complications*
  • Scleroderma, Systemic / diagnostic imaging*
  • Scleroderma, Systemic / immunology
  • Technetium Tc 99m Pentetate
  • Vital Capacity


  • Autoantibodies
  • Radiopharmaceuticals
  • DNA Topoisomerases, Type I
  • Technetium Tc 99m Pentetate