Life Science Journal 2013;10(1) http://www.lifesciencesite.com http://www.lifesciencesite.com lifesciencej@gmail.com 985 Sonographic Measurements of Subdiaphragmatic Length, Diameter, and Diameter to Length Ratio of Esophagus in Gastroesophageal Reflux Disease Diagnosis in Children Masoud Nemati 1 , Mandana Rafeey 2 , Behzad Roozbehani 1 , Abolhassan Shakeri Bavil 3 , Kamyar Ghabili 4 1. Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran 2. Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 3. Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 4. Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran shakeribavil@yahoo.com Abstract: Gastroesophageal reflux disease (GERD) is a common condition among infants and young children. In this age-group, in particular, this condition needs to be diagnosed and treated as early as possible, because any delay may lead to unwanted consequences in terms of their growth and development. Although ultrasonography has been claimed as a sensitive and accurate diagnostic modality, it is time-consuming and difficult to perform in young children. This study aimed to evaluate correlation of some sonographic anatomical parameters of distal esophagus with results of classic sonography in diagnosis of GERD in infants and children. In this cross-sectional analytic- descriptive study, 282 infants and children were recruited. Based on the results of gray-scale conventional sonography, GERD was diagnosed in 185 cases. Length of the subdiaphragmatic esophagus, distal esophageal diameter and wall thickness, and diameter to length ratio were documented by ultrasound and compared between the groups with and without GERD. One hundred and thirty nine boys and 143 girls with a mean age of 16.78±20.99 (range: 1-144) months were enrolled in this study. The length of subdiaphragmatic esophagus was significantly lower in the cases with GERD, while the distal esophageal wall thickness and the diameter to length ratio were significantly higher in the same group. Among the studied sonographic variables, diameter to length ratio was the best indirect indicator of GERD with an optimal cut-off point of 0.45 (sensitivity: 61.1%, specificity: 57.7%). The length of subdiaphragmatic esophagus was predictive of GERD only in the age-group of 12-60 months with low sensitivity and specificity (<42%). This study showed that only the diameter to length ratio of the subdiaphragmatic esophagus might be used to predict GERD among children with limited efficiency. [Nemati M, Rafeey M, Roozbehani B, Bavil AS, Ghabili K. Sonographic Measurements of Subdiaphragmatic Length, Diameter, and Diameter to Length Ratio of Esophagus in Gastroesophageal Reflux Disease Diagnosis in Children. Life Sci J 2013;10(1):985-988] (ISSN:1097-8135). http://www.lifesciencesite.com . 152 Keywords: Gastroesophageal reflex disease; ultrasound; subdiaphragmatic esophagus 1. Introduction Gastroesophageal reflux (GER) is defined as an involuntary passage of gastric contents backwards up into the esophagus, and is a common finding in infants and also seems to be physiological and benign process in neonates (Costa and Campobasso, 1999; Naik et al., 1985; Vandenplas et al., 2009). Gastroesophageal reflux disease (GERD) is the most common esophageal disorder in children and infants (Di Mario et al., 1995). The symptoms associated with GER or GERD can differ depending on the patient’s age and health status. Symptoms of GERD include esophagitis, Barrett’s esophagus, esophageal ulcer, upper GI bleeding and also some respiratory symptoms (Lagergren et al., 1999; Delavari et al., 2012). The classic method of studying GERD is the upper gastrointestinal series with barium (Meschan and Ott, 1984). Recently gastrointestinal ultrasonography (GEUS) has been suggested as an available, noninvasive and sensitive method, providing morphological and functional information (Gomes et al., 1993; Gomes and Menanteau, 1991). These ultrasonographic studies have mainly focused on the evaluation of the gastroesophageal junction and GERD was made by backward of gastric contents into the esophagus (Mittal, 2005; Mittal et al., 2005; Holloway, 2007; Zhu et al., 2004). Although the previous ultrasonographic techniques have been claimed as a sensitive and accurate diagnostic modality, it is time consuming and has difficulties in performance at young children. The aim of this study was to evaluate correlation of some sonographic anatomical parameters of distal esophagus with results of classic sonography in diagnosis of GERD in infants and children. 2. Material and Methods In this cross-sectional analytic-descriptive study, 282 infants and children were recruited from Tabriz Children’s Teaching Centre in a 15-month period from January 2011 to March 2012. Inclusion criteria were the patients aged between 1 month and 14 years with clinical signs and symptoms of GERD.