Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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An Evaluation of Usefulness of FEES Method using Full HD Video that Improves Diagnostic Value of VFSS

Full HD 동영상을 이용한 FEES법이 VFSS의 진단적 가치를 향상 시키는 유용성에 대한 평가

  • Kim, Young-Ran (Department of Radiology, Wonkwang Health Science University) ;
  • Kim, Young-Il (Department of Radiology, Chungnam National University Hospital)
  • 김영란 (원광보건대학교 방사선과) ;
  • 김영일 (충남대학교 병원 영상의학과)
  • Received : 2016.09.01
  • Accepted : 2016.12.08
  • Published : 2016.12.31
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Abstract

Deglutition inspection has been the gold standard for inspection of dysphagia using a penetration device of the division of radiology to date. However, inspection using an endoscope has facilitated diagnosis of dysphagia in recent days. In this study, we compared the results of VFSS alone with those of VFSS combined with FEES to determine if the detection rate of penetration, aspiration, and pharyngeal residue increased. This study evaluated at 130 persons who underwent both VFSS and FEES from December 2013 through March 2014, and used VFSS (FELAVISION, SHIMADZU) and FESS (EVIU LUCERA CV-260SL, OLYMPUS) as devices. After preparing barium diluted solution, yogurt that diluted barium and rice that diluted barium in 2.5 ml, 5 ml, 10 ml by modifying Logemann's protocol in part, and having subjects take the solution, this study confirmed pharyngeal residue, penetration, aspiration etc. VFFS and FEES using full HD video revealed aspiration in 36 of the 130 patients in both inspections. Additionally, aspiration was discovered in 36 patients upon VFFS, but in 41 upon FESS. Although FEES was more sensitive at diagnosing dysphagia, the two inspection methods are complementary, so diagnostic value will be greatly improved when the endoscope operating method and accurate fluoroscopic inspection are combined.

현재까지 연하 장애의 검사법으로 Gold standard 한 검사법은 영상의학과의 투시 장비를 이용한 삼킴 검사법이었다. 그러나 근래에 들어서면서 내시경을 이용한 검사법이 이용되면서 진단에 많은 도움을 주었다. 따라서 본 연구에서는 VFSS와 FEES를 동시에 수행함으로 FEES의 안정성과 유용성을 평가했습니다. 본 연구는 2013년 12월부터 2014년 3월까지 연하 곤란의 진단 또는 평가를 위해 VFSS와 FEES 두 가지 검사를 모두 시행한 130명을 대상으로 하였고, 장비는 VFSS(FELAVISION, SHIMADZU), FESS(EVIU LUCERA CV-260SL, OLYMPUS)을 사용하였다. Logemann의 protocal을 일부 변형하여 2.5 ml, 5 ml, 10 ml의 바륨 희석액, 바륨을 희석한 요거트, 바륨을 희석한 죽, 바륨을 희석한 밥을 준비하여 취식하게 한 후 pharyngeal residue, penetration, aspiration 등을 확인하였다. FULL HD동영상을 사용한 VFFS 검사에서와 FEES 검사에서는 총130명의 환자에서 36명이 두 검사 모두에서 Aspiration이 관찰되었다. 이중 VFFS 에서는 36명이 Aspiration이 발견되었고 FESS에서는 5명이 증가한 41명에서 Aspiration이 관찰되었다. 본 연구에서는 FEES 의 검사법이 연하곤란의 진단에는 더욱 민감하게 검출 되었으나 이 두 가지 검사법은 상호 보완적이기 때문에 보다 숙련된 내시경조작법과 정확한 투시검사가 병행될 때 진단적 가치는 훨씬 향상될 것이다.

Keywords

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