Skip to main content

Imaging of the Esophagus

  • Chapter
  • First Online:
Thoracic Imaging

Abstract

The esophagus is a tubular structure measuring approximately 25 cm in length, connecting the pharynx and the stomach. Most of the esophagus lies in the thorax, with small cervical and intra-abdominal segments. The longest thoracic segment lies posterior to the trachea in the midline, until the tracheal bifurcation, after which it courses slightly left of the midline to cross the diaphragm via the diaphragmatic hiatus and forms the gastroesophageal junction. The abdominal esophagus lies posterior to the left lobe of the liver. The esophagus is therefore composed of a short cervical segment, a long thoracic segment, and a short abdominal segment [1, 2]. The esophageal wall consists of four layers: mucosa, submucosa, muscular layer, and external fibrous layer [3]. The upper third of the esophagus consists of striated muscles, gradually transitioning into completely unstriated muscles in the distal third. Columnar epithelium lines the distal third and gastroesophageal junction, with squamous epithelium lining the rest of the esophagus.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Oezcelik A, DeMeester SR. General anatomy of the esophagus. Thorac Surg Clin. 2011;21(2):289–97.

    Article  PubMed  Google Scholar 

  2. Ha HK, Park SH, Lee S. Gastrointestinal tract. In: Haaga JR, Dogra VS, Forsting M, Gilkeson RC, editors. CT and MRI of the whole body. 5th ed. Philadelphia: Mosby Elsevier; 2009. p. 1213–35.

    Google Scholar 

  3. Godfrey EM, Freeman AH. The oesophagus. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, editors. Grainger & Allison’s diagnostic radiology a textbook of medical imaging. 6th ed. Edinburgh: Churchill Livingstone Elsevier Limited; 2015. p. 610–26.

    Google Scholar 

  4. Sivarao DV, Goyal RK. Functional anatomy and physiology of the upper esophageal sphincter. Am J Med. 2000;108:27S–37S.

    Article  PubMed  Google Scholar 

  5. Kwok H, Marriz Y, Al-Ali S, Windsor JA. Phrenoesophageal ligament re-visited. Clin Anat. 1999;12(3):164–70.

    Article  CAS  PubMed  Google Scholar 

  6. Patti MG, Gantert W, Way LW. Surgery of the esophagus. Anatomy and physiology. Surg Clin North Am. 1997;77(5):959–70.

    Article  CAS  PubMed  Google Scholar 

  7. Godfrey EM, Rushbrook SM, Carroll NR. Endoscopic ultrasound: a review of current diagnostic and therapeutic applications. Postgrad Med J. 2010;86(1016):346–53.

    Article  PubMed  Google Scholar 

  8. Allum WH, Blazeby JM, Griffin SM, Cunningham D, Jankowski JA, Wong R. Guidelines for the management of oesophageal and gastric cancer. Gut. 2011;60(11):1449–72.

    Article  CAS  PubMed  Google Scholar 

  9. Chowdhury FU, Bradley KM, Gleeson FV. The role of 18F-FDG PET/CT in the evaluation of oesophageal carcinoma. Clin Radiol. 2008;63(12):1297–309.

    Article  CAS  PubMed  Google Scholar 

  10. Rabushka L, Fishman E, Kuhlman J. CT evaluation of achalasia. J Comput Assist Tomogr. 1991;15:434–9.

    Article  CAS  PubMed  Google Scholar 

  11. Abubakar U, Bashir MB, Kesieme EB. Pseudoachalasia: a review. Niger J Clin Pract. 2016;19(3):303–7.

    Article  CAS  PubMed  Google Scholar 

  12. Carter M, Deckmann RC, Smith RC, Burrell MI, Traube M. Differentiation of achalasia from pseudoachalasia by computed tomography. Am J Gastroenterol. 1997;92(4):624–8.

    CAS  PubMed  Google Scholar 

  13. Levine MS, Carucci LR, DiSantis DJ, Einstein DM, Hawn MT, Martin-Harris B, et al. Consensus statement of society of abdominal radiology disease-focused panel on barium esophagography in gastroesophageal reflux disease. Am J Roentgenol. 2016;207(5):1009–15.

    Article  Google Scholar 

  14. Levine MS, Carucci LR. Esophageal abnormalities in gastroesophageal reflux disease. Abdom Radiol. 2017;43(6):1284–93.

    Article  Google Scholar 

  15. McCauley RG, Darling DB, Leonidas JC, Schwartz AM. Gastroesophageal reflux in infants and children: a useful classification and reliable physiologic technique for its demonstration. Am J Roentgenol. 1978;130(1):47–50.

    Article  CAS  Google Scholar 

  16. Gordon C, Kang J, Neild P, Maxwell J. The role of the hiatus hernia in gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2004;20(7):719–32.

    Article  CAS  PubMed  Google Scholar 

  17. Marini T, Desai A, Kaproth-Joslin K, Wandtke J, Hobbs SK. Imaging of the oesophagus: beyond cancer. Insights Imaging. 2017;8(3):365–76.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Grubel C, Borovicka J, Schwizer W, Fox M, Hebbard G. Diffuse esophageal spasm. Am J Gastroenterol. 2008;103(2):450–7.

    Article  PubMed  Google Scholar 

  19. Ba-Ssalamah A, Zacherl J, Noebauer-Huhmann IM, Uffmann M, Matzek WK, Pinker K, et al. Dedicated multi-detector CT of the esophagus: spectrum of diseases. Abdom Imaging. 2009;34(1):3–18.

    Article  PubMed  Google Scholar 

  20. Gupta S, Levine MS, Rubesin SE, Katzka DA, Laufer I. Usefulness of barium studies for differentiating benign and malignant strictures of the esophagus. AJR Am J Roentgenol. 2003;180(3):737–44.

    Article  PubMed  Google Scholar 

  21. Spechler SJ. Part 1. Oral cavity, pharynx and esophagus. GI Motil online. 2006. https://doi.org/10.1038/gimo44.

  22. Cossentino MJ, Wong RKH. Barrett’s esophagus and risk of esophageal adenocarcinoma. Semin Gastrointest Dis. 2003;14(3):128–35.

    PubMed  Google Scholar 

  23. Rabushka LS, Fishman EK, Kuhlman JE, Hruban RH. Diffuse esophageal leiomyomatosis in a patient with Alport syndrome: CT demonstration. Radiology. 1991;179(1):176–8.

    Article  CAS  PubMed  Google Scholar 

  24. Berliner L, Redmond P, Horowitz L, Ruoff M. Glycogen plaques (glycogenic acanthosis) of the esophagus. Radiology. 1981;141(3):607–10.

    Article  CAS  PubMed  Google Scholar 

  25. Whitaker JA, Deffenbaugh LDCA. Esophageal duplication cyst. Am J Gastroenterol. 1980;73:329–32.

    CAS  PubMed  Google Scholar 

  26. Feguson CC, Young LN, Sutherland JBMR. Intrathoracic gastrogenic cyst-preoperative diagnosis by technetium scan. J Pediatr Surg. 1973;8:827–8.

    Article  Google Scholar 

  27. Fitch SJ, Tonkin IL, Tonkin AK. Imaging of foregut duplication cysts. Radiographics. 1986;6(2):189–201.

    Article  CAS  PubMed  Google Scholar 

  28. Weiss L, Fragelman DWJ. CT demonstration of an esophageal duplication cyst. J Comput Assist Tomogr. 1983;7:716–8.

    Article  CAS  PubMed  Google Scholar 

  29. Kuhlman JE, Fishman EK, Wang KP, Siegelman SS. Esophageal duplication cyst: CT and transesophageal needle aspiration. Am J Roentgenol. 1985;145(3):531–2.

    Article  CAS  Google Scholar 

  30. Jeung M-Y, Gasser B, Gangi A, Bogorin A, Charneau D, Wihlm JM, et al. Imaging of cystic masses of the mediastinum. Radiographics. 2002;22(suppl_1):S79–93.

    Article  PubMed  Google Scholar 

  31. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7–30.

    Article  PubMed  Google Scholar 

  32. Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer. 1999;83(1):18–29.

    Article  CAS  PubMed  Google Scholar 

  33. Jemal A, Tiwari RC, Murray T, Ghafoor A, Samuels A, Ward E, et al. Cancer statistics, 2004. CA Cancer J Clin. 2004;54(1):8–29.

    Article  PubMed  Google Scholar 

  34. Hong SJ, Kim TJ, Lee IS, Yang HC, Kim K. New TNM staging system for esophageal cancer: what chest radiologists need to know. Radiographics. 2014;34(6):1722–41.

    Article  PubMed  Google Scholar 

  35. Rice TW, Patil DT, Blackstone EH. 8th edition AJCC/UICC staging of cancers of the esophagus and esophagogastric junction: application to clinical practice. Ann Cardiothorac Surg. 2017;6:119–30.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Rice TW, Ishwaran H, Ferguson MK, Blackstone EH, Goldstraw P. Cancer of the esophagus and esophagogastric junction: an eighth edition staging primer. J Thorac Oncol. 2018;12(1):36–42.

    Article  Google Scholar 

  37. Ajani JAB. Esophageal and esophagogastric junction cancers. J Natl Compr Cancer Netw. 2015;9(8):830–87.

    Article  Google Scholar 

  38. Picus D, Balfe DM, Koehler RE, Roper CL, Owen JW. Computed tomography in the staging of esophageal carcinoma. Radiology. 1983;146(2):433–8.

    Article  CAS  PubMed  Google Scholar 

  39. Mori M, Matsukama A, Adachi Y, Al E. Small cell carcinoma of the oesophagus. Cancer. 1989;63:564–73.

    Article  CAS  PubMed  Google Scholar 

  40. Levine MS, Pantongrag-Brown L, Buck JL, Buetow PC, Lowry MA, Sobin LH. Small-cell carcinoma of the esophagus: radiographic findings. Radiology. 1996;199(3):703–5.

    Article  CAS  PubMed  Google Scholar 

  41. Levine MS, Buck JL, Pantongrag-Brown L, Buetow PC, Hallman JR, Sobin LH. Leiomyosarcoma of the esophagus: radiographic findings in 10 patients. AJR Am J Roentgenol. 1996;167(1):27–32.

    Article  CAS  PubMed  Google Scholar 

  42. Nishida T, Hirota S. Biological and clinical review of stromal tumours in the gastrointestinal tract. Histol Histopathol. 2000;15:1293–301.

    CAS  PubMed  Google Scholar 

  43. Sandrasegaran K, Rajesh A, Rushing D, Et A. Gastrointestinal stromal tumours: CT and MRI findings. Eur Radiol. 2005;15:1407–14.

    Article  PubMed  Google Scholar 

  44. Young CA, Menias CO, Bhalla S, Prasad SR. CT features of esophageal emergencies. Radiographics. 2008;28(6):1541–53.

    Article  PubMed  Google Scholar 

  45. Currie S, Menias CO, Mellnick V. Imaging of esophageal emergencies. Appl Radiol. 2016;45(10):16–21.

    Google Scholar 

  46. Sparberg M. Roentgenographic documentation of the Mallory-Weiss syndrome. JAMA. 1968;203(2):151–2.

    Article  CAS  PubMed  Google Scholar 

  47. Ghanem N, Altehoefer C, Springer O, Et A. Radiological findings in Boerhaave’s syndrome. Emerg Radiol Emerg Radiol. 2003;10(1):8–13.

    PubMed  Google Scholar 

  48. Khawaja FI, Varindani MK. Aortoesophageal fistula. Review of clinical, radiographic, and endoscopic features. J Clin Gastroenterol. 1987;9:342–4.

    Article  CAS  PubMed  Google Scholar 

  49. Hollander JE, Quick G. Aortoesophageal fistula: a comprehensive review of the literature. Am J Med. 1991;91:279–87.

    Article  CAS  PubMed  Google Scholar 

  50. Hou PY, Teng CJ, Chung CS, Liu CY, Huang CC, Chang MH, Shueng PW, Hsieh CH. Aortic pseudoaneurysm formation following concurrent chemoradiotherapy and metallic stent insertion in a patient with esophageal cancer. Medicine (Baltimore). 2015;94(20):862.

    Article  Google Scholar 

  51. Sivaraman SK, Drummond R. Radiation-induced aortoesophageal fistula: an unusual case of massive upper gastrointestinal bleeding. J Emerg Med. 2002;23:175–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pratik Mukherjee .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Mukherjee, P., Lim, T.C., Chawla, A. (2019). Imaging of the Esophagus. In: Chawla, A. (eds) Thoracic Imaging. Springer, Singapore. https://doi.org/10.1007/978-981-13-2544-1_11

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-2544-1_11

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-2543-4

  • Online ISBN: 978-981-13-2544-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics