Oesophageal dilatation on high-resolution computed tomography scan of the lungs as a sign of scleroderma

Abstract

Oesophageal dilatation as visible on an HRCT scan of the chest may alert doctors to look for other signs or symptoms of SSc in these patients, enabling early diagnosis and specific treatment.

Computed Tomography of the Esophagus in Scleroderma and Lung Disease

“…It is well known that the esophagus is dilated in systemic sclerosis (Bhalla et al 1993;Pitrez et al 2006;Vonk et al 2008;Patiwetwitoon et al 2012), but its precise measurements and association with lung disease had not been done before. The finding of retained food and liquid also indicates esophageal dysfunction.…”

“…The CT image of esophagus, if correlated with function, has several practical advantages over conventional methods to evaluate esophageal dysfunction: availability, noninvasiveness, easy repeatability, and little need of patient cooperation. However, previous studies demonstrated conflicting results in the correlation between esophageal dilation on CT and interstitial lung disease in systemic sclerosis patients (Vonk et al 2008;Patiwetwitoon et al 2012).…”

“…The finding of retained food and liquid also indicates esophageal dysfunction. CT studies have called esophageal dilation with coronal lumen more than 10 mm (Bhalla et al 1993;Vonk et al 2008) or the widest coronal esophageal diameter at 3 levels (the mid-arch of the aorta, the main carina, and the diaphragmatic hiatus) more than 10 mm (Patiwetwitoon et al 2012). Our previous report SSc w/ ILD: systemic sclerosis patients with interstitial lung disease; SSc w/o ILD: systemic sclerosis patients without interstitial lung disease; Pulm: patients from a pulmonary clinic.…”

“…It has been suggested that esophageal dysfunction and aspiration may play a role in pathogenesis of interstitial lung disease in systemic sclerosis and other lung diseases (el-Serag and Sonnenberg 1997; Tobin et al 1998;Marie et al 2001;Savarino et al 2009;Christmann et al 2010). Esophageal dilation on CT scan correlates well with esophageal dysfunction (Pitrez et al 2006;Vonk et al 2008). The CT image of esophagus, if correlated with function, has several practical advantages over conventional methods to evaluate esophageal dysfunction: availability, noninvasiveness, easy repeatability, and little need of patient cooperation.…”

“…While several studies reported the prevalence of esophageal dilation on chest CT scans for systemic sclerosis patients, these studies used empirical cutoff values to define esophageal dilation without regard to normal standards (Bhalla et al 1993;Pitrez et al 2006;Vonk et al 2008;Patiwetwitoon et al 2012).…”