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Research article
Yong Hou
Peking Union Medical College hospital, Chinese Academy of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9534-6965
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: The esophagus involvement in systemic sclerosis (SSc) is very common yet underestimated due to the lack of suitable evaluation tools. This study aims to explore the usefulness of ultrasound (US) in the assessment of esophagus involvement and to identify its relationship with clinical and CT manifestations.
Methods: We performed esophageal US in 38 SSc patients and 38 controls. US parameters including the abdominal esophagus length, esophagus wall thickness, shear-wave elastography, gastro-esophageal (His) angle, and reflux were compared. Relationships between distinguishable US parameters and clinical/CT parameters, such as gastro-esophageal reflux disease questionnaire (GERDQ), modified Rodnan skin score (mRSS), interstitial lung disease (ILD) score, the largest esophagus diameter (Dmax), and esophagus dilation percentage (%Eop), were evaluated.
Results: Abdominal esophagus length was shorter in the SSc group than the control group (2.69 cm vs 3.06 cm, P=0.018), while His angle and the angle change before and after drinking water were larger in the SSc group than the control group (121°vs 108°, P=0.000; 7.97°vs 2.92°, P=0.025). Reflux was more frequently seen in the SSc group than the control group (7/38 vs 0/38; P=0.017). As for correlation with clinical and CT parameters, His angle was higher in patients with GERDQ ≥ 8 than GERDQ < 8 (116.5°vs 125.6°, P=0.035). Patients with reflux showed higher ILD score than patients without (15.8 vs 9.6, P=0.043). Furthermore, abdominal esophagus length was negatively correlated with %Eop and Dmax (r=-0.573, P<0.001; r=-0.476, P=0.003),
Conclusion: US parameters of the esophagus can distinguish SSc patients from controls, as well as had correlations with clinical and CT characteristics. Our study firstly shows that US can be used as a noninvasive and convenient method to evaluate the esophagus involvement in SSc.
Keywords
systemic sclerosis, esophagus involvement, ultrasound
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View the published article at Arthritis Research & Therapy.
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Editorial decision: Major revision
On 28 Feb, 2021
Review #2 received
Received 21 Feb, 2021
Review #1 received
Received 21 Feb, 2021
Reviewer #2 agreed
On 13 Feb, 2021
Reviewer #1 agreed
On 13 Feb, 2021
Reviews received
Received 13 Feb, 2021
Reviewers invited
Invitations sent on 13 Feb, 2021
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On 31 Jan, 2021
Editor invited
On 31 Jan, 2021
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Subject Areas
Rheumatology
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A new preprint design is coming!
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See the published version of this preprint at Arthritis Research & Therapy.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yong Hou
Peking Union Medical College hospital, Chinese Academy of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9534-6965
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Arthritis Research & Therapy.
Version 1
Posted 04 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 28 Feb, 2021
Review #2 received
Received 21 Feb, 2021
Review #1 received
Received 21 Feb, 2021
Reviewer #2 agreed
On 13 Feb, 2021
Reviewer #1 agreed
On 13 Feb, 2021
Reviews received
Received 13 Feb, 2021
Reviewers invited
Invitations sent on 13 Feb, 2021
Submission checks complete
On 31 Jan, 2021
Editor invited
On 31 Jan, 2021
Editor assigned
On 30 Jan, 2021
First submitted
On 28 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Rheumatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Arthritis Research & Therapy.
Background: The esophagus involvement in systemic sclerosis (SSc) is very common yet underestimated due to the lack of suitable evaluation tools. This study aims to explore the usefulness of ultrasound (US) in the assessment of esophagus involvement and to identify its relationship with clinical and CT manifestations.
Methods: We performed esophageal US in 38 SSc patients and 38 controls. US parameters including the abdominal esophagus length, esophagus wall thickness, shear-wave elastography, gastro-esophageal (His) angle, and reflux were compared. Relationships between distinguishable US parameters and clinical/CT parameters, such as gastro-esophageal reflux disease questionnaire (GERDQ), modified Rodnan skin score (mRSS), interstitial lung disease (ILD) score, the largest esophagus diameter (Dmax), and esophagus dilation percentage (%Eop), were evaluated.
Results: Abdominal esophagus length was shorter in the SSc group than the control group (2.69 cm vs 3.06 cm, P=0.018), while His angle and the angle change before and after drinking water were larger in the SSc group than the control group (121°vs 108°, P=0.000; 7.97°vs 2.92°, P=0.025). Reflux was more frequently seen in the SSc group than the control group (7/38 vs 0/38; P=0.017). As for correlation with clinical and CT parameters, His angle was higher in patients with GERDQ ≥ 8 than GERDQ < 8 (116.5°vs 125.6°, P=0.035). Patients with reflux showed higher ILD score than patients without (15.8 vs 9.6, P=0.043). Furthermore, abdominal esophagus length was negatively correlated with %Eop and Dmax (r=-0.573, P<0.001; r=-0.476, P=0.003),
Conclusion: US parameters of the esophagus can distinguish SSc patients from controls, as well as had correlations with clinical and CT characteristics. Our study firstly shows that US can be used as a noninvasive and convenient method to evaluate the esophagus involvement in SSc.
Figure 1
Figure 2
Figure 3
Figure 4
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