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The spectrum of benign esophageal lesions: imaging findings.

Jang KM, Lee KS, Lee SJ, Kim EA, Kim TS, Han D, Shim YM - Korean J Radiol (2002 Jul-Sep)

Bottom Line: Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease.Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread.In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
Benign esophageal lesions occur in various diseases. Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease. Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread. In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up. The advent of helical computed tomography and its volume data set allows the acquisition of multiplanar images, and magnetic resonance imaging is useful both for this and for tissue characterization. Thus, multiplanar cross-sectional imaging further extends the role of imaging modalities to the evaluation of benign esophageal lesions. Through an awareness of the multiplanar cross-sectional appearances of various benign esophageal lesions, the radiologist can play an important role in the detection, diagnosis, further diagnostic planning, and treatment of the diseases in which they occur.

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Epiphrenic esophageal diverticulum in a 63-year-old man.A. Mediastinal window of enhanced (7-mm collimation) CT scan obtained at the level of the suprahepatic inferior vena cava shows that outpouching (arrows) from the esophagus contains an air-fluid level.B. CT scan obtained at the level of the liver dome shows that the position of the esophagogastric junction (arrow) is normal.
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Figure 17: Epiphrenic esophageal diverticulum in a 63-year-old man.A. Mediastinal window of enhanced (7-mm collimation) CT scan obtained at the level of the suprahepatic inferior vena cava shows that outpouching (arrows) from the esophagus contains an air-fluid level.B. CT scan obtained at the level of the liver dome shows that the position of the esophagogastric junction (arrow) is normal.

Mentions: Diverticula may be formed either by pulsion due to increased intraluminal esophageal pressure or by traction due to fibrosis in adjacent periesophageal tissue. Pulsion esophageal diverticula, which have a round contour and wide neck, consist only of mucosa, without a muscular layer. Traction diverticula, on the other hand, contain all layers of the esophageal wall, including muscle. Diverticula may be classified according to their location (29), the most common of which are the pharyngoesophageal junction (e.g. Zenker's diverticulum, pulsion type), the middle esophagus (mostly the traction type), and the distal esophagus just above the esophageal hiatus (e.g. epiphrenic diverticulum, pulsion type) (Fig. 17). Because their walls contain no muscle, pulsion diverticula tend to remain filled after the esophagus has emptied of barium. When the esophagus collapses, traction diverticula tend to empty.


The spectrum of benign esophageal lesions: imaging findings.

Jang KM, Lee KS, Lee SJ, Kim EA, Kim TS, Han D, Shim YM - Korean J Radiol (2002 Jul-Sep)

Epiphrenic esophageal diverticulum in a 63-year-old man.A. Mediastinal window of enhanced (7-mm collimation) CT scan obtained at the level of the suprahepatic inferior vena cava shows that outpouching (arrows) from the esophagus contains an air-fluid level.B. CT scan obtained at the level of the liver dome shows that the position of the esophagogastric junction (arrow) is normal.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2713885&req=5

Figure 17: Epiphrenic esophageal diverticulum in a 63-year-old man.A. Mediastinal window of enhanced (7-mm collimation) CT scan obtained at the level of the suprahepatic inferior vena cava shows that outpouching (arrows) from the esophagus contains an air-fluid level.B. CT scan obtained at the level of the liver dome shows that the position of the esophagogastric junction (arrow) is normal.
Mentions: Diverticula may be formed either by pulsion due to increased intraluminal esophageal pressure or by traction due to fibrosis in adjacent periesophageal tissue. Pulsion esophageal diverticula, which have a round contour and wide neck, consist only of mucosa, without a muscular layer. Traction diverticula, on the other hand, contain all layers of the esophageal wall, including muscle. Diverticula may be classified according to their location (29), the most common of which are the pharyngoesophageal junction (e.g. Zenker's diverticulum, pulsion type), the middle esophagus (mostly the traction type), and the distal esophagus just above the esophageal hiatus (e.g. epiphrenic diverticulum, pulsion type) (Fig. 17). Because their walls contain no muscle, pulsion diverticula tend to remain filled after the esophagus has emptied of barium. When the esophagus collapses, traction diverticula tend to empty.

Bottom Line: Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease.Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread.In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
Benign esophageal lesions occur in various diseases. Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease. Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread. In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up. The advent of helical computed tomography and its volume data set allows the acquisition of multiplanar images, and magnetic resonance imaging is useful both for this and for tissue characterization. Thus, multiplanar cross-sectional imaging further extends the role of imaging modalities to the evaluation of benign esophageal lesions. Through an awareness of the multiplanar cross-sectional appearances of various benign esophageal lesions, the radiologist can play an important role in the detection, diagnosis, further diagnostic planning, and treatment of the diseases in which they occur.

Show MeSH
Related in: MedlinePlus