Imaging of Nonneoplastic Esophageal Pathologies
The esophagus is an organ which consists of a fibromuscular tube which enables the passage of food. This transmission is aided by peristaltic contractions, from the pharynx to the stomach, where the process of digestion reaches the acme. Efficient transport through the esophagus requires the organ either to be patent and well canalized or to have adequate motility. This consists of coordinating sequential contraction that mobilizes the bolus from above and clears acid and bile reflux from below. Dysfunction of this integrated muscular motion reduces progression of bolus and causes a distressing sense of dysphagia, chest pain, and regurgitation, or leads to other severe conditions (i.e., ab ingestis pneumonia).
In this scenario modern imaging techniques, either invasive or noninvasive, concede an early and accurate diagnosis that radically changed the approach to those disorders. In fact a predominant role is played by contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI), but conventional radiology (barium esophagography; endoscopic ultrasonography, EUS) is still essential. Among those techniques, dynamic MRI of the esophagus has developed a great potential, with the introduction of ultrafast MR sequences, which have decreased scan times, granting a minor exposure to ionizing radiation.
KeywordsEsophagus Esophagus congenital malformation Esophagus motility Hiatus hernia Esophageal trauma Esophageal atresia Achalasia Esophagitis, reflux
Congenital esophageal stenosis
Diffuse esophageal spasm
Gastroesophageal reflux disease
Ineffective esophageal motility
Magnetic resonance imaging
Nonspecific esophageal motility dysfunction
Scleroderma of the esophagus
Upper esophageal sphincter
- 2.Ekberg O. Normal anatomy and techniques of examination of the esophagus: fluoroscopy, CT, MRI, and scintigraphy. In: Freeny PC, Stevenson GW, editors. Margulis and Burhenne’s alimentary tract radiology. 5th ed. St. Louis: Mosby; 1994. p. 168–85.Google Scholar
- 4.Vaz M, Raj T, Anura K. Guyton & Hall textbook of medical physiology. 2nd ed. New Delhi: Elsevier; 2016. p. 747–8.Google Scholar
- 6.Panebianco V, Tomei E, Anzidei M, Habib FI, Catalano C, Lisi D, Laghi A, Passariello R. Functional MRI in the evaluation of oesophageal motility: feasibility, MRI patterns of normality, and preliminary experience in subjects with motility disorders. Radiol Med. 2006;111(7):881–9. Accessed 11 Oct 2006.CrossRefPubMedGoogle Scholar
- 7.Covotta F, Piretta L, Badiali D, Laghi A, Biondi T, Corazziari ES, Panebianco V. Functional magnetic resonance in the evaluation of oesophageal motility disorders. Gastroenterol Res Pract. 2011;2011:367639. https://doi.org/10.1155/2011/367639. Accessed 29 Aug 2011.CrossRefPubMedPubMedCentralGoogle Scholar
- 8.Panebianco V, Habib FI, Tomei E, Paolantonio P, Anzidei M, Laghi A, Catalano C, Passariello R. Initial experience with magnetic resonance fluoroscopy in the evaluation of oesophageal motility disorders. Comparison with manometry and barium fluoroscopy. Eur Radiol. 2006;16(9):1926–33. Accessed 26 April 2006.CrossRefPubMedGoogle Scholar
- 16.Boyce HW Jr, Boyce G. Esophagus: anatomy and structural anomalies. In: Yamada T, editor. Textbook of gastroenterology. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003. p. 1148–65.Google Scholar
- 18.James B, Nelson MD, Donald O, Castell MD. Esophageal motility disorders. (2015). http://www.uptodate.com/contents/. Accessed 19 Dec 2014.
- 19.Dellon ES, Gibbs WB, Fritchie KJ, Rubinas TC, Wilson LA, Woosley JT, et al. Clinical, endoscopic, and histologic findings distinguish eosinophilic esophagitis from gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2009;7(12):1305–13; quiz 1261. Accessed Dec 2009.CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Società Italiana di Endoscopia Digestiva (S.I.E.D.). Linee guida per la rimozione endoscopica di corpi estranei. Clinical Guideline 1995.Google Scholar