Document Detail


The small-caliber esophagus: radiographic sign of idiopathic eosinophilic esophagitis.
MedLine Citation:
PMID:  20505062     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate a small-caliber esophagus at barium esophagography with idiopathic eosinophilic esophagitis (IEE) and determine if there is a useful threshold diameter for suggesting this diagnosis. MATERIALS AND METHODS: The institutional review board approved this retrospective study and waived informed consent. This study was HIPAA compliant. A search of the radiology database (by using the search term small-caliber esophagus) revealed 10 patients with a small-caliber esophagus at barium esophagography who had IEE (defined as more than 20 eosinophils per high-power field in endoscopic biopsy specimens). Images were reviewed to characterize findings and determine the length of narrowing. Luminal diameters were measured at three levels for nine patients and nine control subjects, and mean diameter, range, and standard deviation were determined at each level. An analysis of variance test was performed to determine whether the difference between the range of mean thoracic esophageal diameters in patients with IEE versus that in control subjects was significant. RESULTS: All 10 patients had long-segment but variable-length narrowing of the thoracic esophagus (mean length, 15.4 cm) with tapered margins. The mean diameter at the aortic arch, carina, and one vertebral body above the gastroesophageal junction was 13.9, 14.3, and 15.1 mm, respectively, for patients with small-caliber esophagus versus 20.2, 30.3, and 28.7 mm for control subjects. The mean overall diameter was 14.7 mm for patients with small-caliber esophagus versus 26.3 mm for control subjects. In the nine patients in whom the luminal diameter was measured, the mean thoracic esophageal diameter was 20 mm or less; all nine control subjects had a mean thoracic esophageal diameter greater than 20 mm. The difference in the range of mean thoracic esophageal diameters between these two groups was highly significant (P < .0001), so 20 mm was a useful threshold diameter for suggesting this diagnosis. CONCLUSION: The small-caliber esophagus of IEE is characterized at barium esophagography by long-segment but variable-length narrowing of the thoracic esophagus, with a mean length of 15.4 cm, a diameter of 20 mm or less, smooth contours, and tapered margins.
Authors:
Sarah B White; Marc S Levine; Stephen E Rubesin; Geoffrey S Spencer; David A Katzka; Igor Laufer
Publication Detail:
Type:  Journal Article     Date:  2010-05-26
Journal Detail:
Title:  Radiology     Volume:  256     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-24     Completed Date:  2010-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  127-34     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Barium Sulfate / diagnostic use
Contrast Media / diagnostic use
Eosinophilia / etiology,  radiography*
Esophageal Stenosis / complications,  radiography*
Esophagitis / etiology,  radiography*
Esophagoscopy
Female
Humans
Male
Middle Aged
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Chemical
Reg. No./Substance:
0/Contrast Media; 7727-43-7/Barium Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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