Continuous imaging of esophagogastric junction in patients with reflux esophagitis using 320‐row area detector <scp>CT</scp>: A feasibility study

Fukazawa, Kousuke; Furuta, K.; Adachi, Kyoichi; Shimura, Shino; Kamiyama, Kazutoshi; Aimi, Masahito; Ohara, Shunji; Kajitani, Takafumi; Tsurusaki, Masakatsu; Kitagaki, Hajime; Kinoshita, Yoshikazu

doi:10.1111/jgh.12267

Cited by 7 publications

(12 citation statements)

References 37 publications

(69 reference statements)

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“…As a result, the angle of His also increases, and there is no longer a subdiaphragmatic segment of the esophagus, namely the abdominal esophagus, to be compressed. Several studies using CT or MRI showed that the angle of His was wider (more obtuse) in GERD patients than in healthy subjects [ 11 , 12 ]. In the present study, the angle of His was wider in patients with abnormal GEFV than it was in those with normal GEFV.…”

Section: Discussionmentioning

confidence: 99%

“…The final data for each subject were obtained by calculating the mean measurement values by the two experts. The angle of His, hiatal hernia, size of the diaphragmatic hiatus, and length of the abdominal esophagus were measured using CT images using methods of previous study [ 12 ]. The techniques of the following measurements performed by gastroenterologist were verified and closely monitored by two radiologist (N.K.L.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have shown morphological changes at the GEJ in patients with gastroesophageal reflux disease (GERD) [ 11 , 12 ] and have provided strong evidence for the structural components of reflux protection by the ‘flap valve’ mechanism using magnetic resonance imaging (MRI) and computed tomography (CT) [ 11 - 14 ]. A recent study that analyzed CT images showed a more frequent occurrence of hiatal hernia, a greater angle of His, and a larger diaphragmatic hiatus in patients with severe reflux esophagitis [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Analysis of computed tomographic findings according to gastroesophageal flap valve grade

Jeon

Kim

Lee

et al. 2018

Korean J Intern Med

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Background/AimsThe gastroesophageal junction is an important barrier against gastroesophageal ref lux. Endoscopic grading of gastroesophageal f lap valve is simple, reproducible, and may predict reflux activity. We investigated the correlation between gastroesophageal flap valve grade and the gastroesophageal junction’s structural properties using abdominal computed tomography.MethodsA total of 138 patients with early gastric cancer who underwent both pre-treatment esophagogastroduodenoscopy and water-distended stomach two-phase computed tomography were enrolled. Endoscopic gastroesophageal f lap valve grade and abdominal computed tomography findings were analyzed to assess anatomical factors including the gastroesophageal junction and related organs.ResultsThe angle of His increased significantly with gastroesophageal flap valve grade (grade I, 65.2˚ ± 19.6˚; grade II, 66.6˚ ± 19.8˚; grade III, 76.7˚ ± 11.9˚; grade IV, 120.0˚ ± 30.3˚; p < 0.001), as did the size of the diaphragmatic hiatus (grade I, 213.0 ± 53.8 mm2 ; grade II, 232.6 ± 71.0 mm2 ; grade III, 292.3 ± 99.2 mm2 ; grade IV, 584.4 ± 268.3; p < 0.001). The length of the abdominal esophagus decreased as gastroesophageal flap valve grade increased (grade I, 34.6 ± 5.8 mm; grade II, 32.0 ± 6.5 mm; grade III, 24.6 ± 7.8 mm; grade IV, –22.6 ± 38.2 mm; p < 0.001). There was no significant relationship between gastroesophageal flap valve grade and visceral and subcutaneous fat areas (p = 0.877 and p = 0.508, respectively).ConclusionsEndoscopic grading of the gastroesophageal flap valve is well correlated with anatomical changes around the gastroesophageal junction on abdominal computed tomography, and it can provide useful information about the anti-reflux barrier.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of computed tomographic findings according to gastroesophageal flap valve grade

Jeon

Kim

Lee

et al. 2018

Korean J Intern Med

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“…In spite of recent advances in continuous imaging with 320 row area detector CT scan as described by Fukazawa et al [18], and positron emission tomography/computed tomography (PET/CT) as reported by Wu et al [19] for gastrointestinal disorders, these imaging modalities are not standard of care for diagnosis of GERD, so detection of ED on chest CT scan or high-resolution chest CT scan (HRCT ) is an incidental and challenging finding. Firstly, esophageal stasis may predis- …”

Section: Discussionmentioning

confidence: 99%

Association of esophageal dilatation in chest CT scan with gastroesophageal reflux disease: A case control study

Hashemi

Moosavi²,

Idani³

et al. 2018

Monaldi Arch Chest Dis

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The presence of increased air bubble in the lumina of esophagus on a chest CT scan may be associated with esophageal disorders. The purpose of this study was to determine the association between the appearance of air bubbles on chest CT scan and gastroesophageal Reflux Disease (GERD). In this case-control study, thirty-two patients with endoscopically proved GERD and 32 subjects without GERD underwent chest computed tomography (CT) scanning. Esophageal dilatation (ED) was defined as the presence of air bubbles greater than 10 mm in the supra ventricle (SV) and ventricle (CV), and air bubbles >15 mm in the ventricle to the lower esophageal sphincter (V-LES). The results were compared between the two groups. The GERD patients included 16 (50%) males with a mean age of 58.5±11.2 years and the control group included 17 (54.8%) males and 14 (45.1%) females with a mean age of 66.7±10.5 years. There was a significant relationship between the presence of GERD and esophageal dilation (ED) in the V-LES sections on the CT scan (P=0.002). The mean size of the air bubbles in the V-LES section was 11.73 mm in the case group in comparison to 4.32 mm in the control group (P<0.001). The size and location of the air bubbles in the esophagus can vary and be important. The possibility of GERD increases in the presence of esophageal dilation on CT scan.

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“…An acute esophagogastric insertion angle has been shown to be necessary to act as a flap‐valve mechanism to protect against gastroesophageal reflux, since progressive filling of the gastric fundus compresses the intra‐abdominal portion of the esophagus and reduces EGJ opening during transient LES relaxations . Widening of this angle was enlarged in patients with GERD, assessed by MRI and CT . Videofluoroscopy is often the first investigation method in patients with unspecific swallowing complaints and may show a funnel‐shaped or gaping cardia combined with widening of the angle of His and the EGJ, indicative of GERD and requiring further endoscopic and manometric workup.…”

Section: Cardiamentioning

confidence: 99%

What is the role of radiological testing of lower esophageal sphincter function?

Scharitzer¹,

Pokieser

2016

Annals of the New York Academy of Sciences

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Radiological fluoroscopic evaluation remains the primary imaging modality of choice to evaluate patients with swallowing disorders, despite the increasing availability and technical advantages of nonradiological techniques and the current radiological focus on cross-sectional imaging studies, such as computed tomography and magnetic resonance imaging. The radiological swallowing evaluation should be tailored to assess the entire upper gastrointestinal tract, including the lower esophageal sphincter. Fluoroscopy enables the simultaneous assessment of esophageal motility disorders, as well as structural pathologies, including strictures, webs, rings, diverticula, and tumors. Mono- and double-contrast esophagrams and solid bolus tests together allow assessment of lower esophageal sphincter function and complement other methods, such as endoscopy, manometry, or impedance planimetry. Here we review the role of radiological studies for correct assessment of structural and functional pathologies at the level of the lower esophageal sphincter.

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Continuous imaging of esophagogastric junction in patients with reflux esophagitis using 320‐row area detector CT: A feasibility study

Abstract: Continuous imaging with 320-row area detector CT is useful to evaluate morphological changes in the esophagogastric junction area in both normal individuals and patients with reflux esophagitis.

Cited by 7 publications

References 37 publications

Analysis of computed tomographic findings according to gastroesophageal flap valve grade

Analysis of computed tomographic findings according to gastroesophageal flap valve grade

Association of esophageal dilatation in chest CT scan with gastroesophageal reflux disease: A case control study

What is the role of radiological testing of lower esophageal sphincter function?

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