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| The role of CT imaging and X-ray barium examination in the evaluation of esophageal inlet lesions |
PAN Yu-ping1, ZHUANG Qi-xin1, GU Yi-feng1, WANG Ji-long1, ZHOU Jian-qin2, YIN Shan-kai1, LI Ming-hua1
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| 1. Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai 200233, China;2. Department of Radiology, Xiangshan First People’s Hospital, Xiangshan Zhejiang 315700, China |
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Abstract Objective: To analyze the radiological features of esophageal inlet lesions by CT and barium study in order to improve the diagnostic accuracy. Methods: The clinical and radiological data of 34 cases with esophageal inlet lesions were retrospectively analyzed. All cases were pathologically confirmed by surgery or biopsy. Twenty-seven patients underwent CT scan with contrast and 7 patients underwent plain CT scan. Twenty-eight patients underwent barium study. Results: Surgery or biopsy revealed 14 cases with primary esophageal tumor(12 cases of squamous carcinoma and 2 cases of undifferentiated cancer), 3 cases were hypertrophy of sphincter, 5 cases were diverticulum, 12 cases were due to trauma. All patients presented with dysphagia. In cases with late stage esophageal cancer, barium study showed mucosa destruction. CT scan may have negative findings in patients with early stage cancer while irregular thickening of esophagus or intra-luminal mass can be found in patients of late stage. In cases of hypertrophy of esophageal sphincter, CT scan showed localized wall thickening of esophagus with smooth mucosa. In cases of esophageal diverticulum, CT scan revealed unenhanced mass of esophageal inlet. Barium study showed niche filling with contrast. In patients with esophageal perforation, barium study showed contrast dissemination into cervical soft tissue. In 2 cases of esophageal perforation with superior mediastinal abscess, CT scan showed low density lesion with typical ring-like enhancement. Conclusion: Concerning low-cost, convenience and easy-to-perform, barium study remains irreplaceable in diagnosis of esophageal inlet lesions. CT is significant in staging of esophageal tumor and evaluation of esophageal trauma and its complications. Combining both methods can improve the diagnostic accuracy of esophageal inlet lesions.
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Received: 17 December 2009
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Corresponding Authors:
ZHUANG Qi-xin
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2010, Vol. 21 
