Oesophageal dilatation on high-resolution CT chest in systemic sclerosis: What does it signify?

Pandey, Anoop Kumar; Wilcox, Pearce; Mayo, John R.; Moss, Robert; Ellis, Jennifer D.; Brown, Jacquie; Kavishwar, Arvind; Leipsic, Jonathon

doi:10.1111/j.1754-9485.2011.02317.x

Cited by 17 publications

(19 citation statements)

References 20 publications

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“…fibrosis score + ground glass extent), with similar findings for all analyses (data not shown). Oesophageal diameter was measured as the maximum coronal diameter from thoracic inlet to oesophageal hiatus . In a previous study of normal volunteers, maximal oesophageal diameter (defined as the largest linear measurement of oesophageal air) was 9.7 mm (95%CI: 6.9 to 14.1) .…”

Section: Methodsmentioning

confidence: 99%

“…Oesophageal diameter was measured as the maximum coronal diameter from thoracic inlet to oesophageal hiatus. 14,15 In a previous study of normal volunteers, maximal oesophageal diameter (defined as the largest linear measurement of oesophageal air) was 9.7 mm (95%CI: 6.9 to 14.1). 16 Additional measurements included the presence of a hiatal hernia (oesophageal hiatus >1.5 cm and/or gastric structures above the hiatus), tracheal debris (dependent increased attenuation) and mucoid impaction (distal airways completely occluded by presumed mucous).…”

Section: Hrct Measurementsmentioning

confidence: 96%

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Oesophageal diameter is associated with severity but not progression of systemic sclerosis‐associated interstitial lung disease

et al. 2018

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Section: Methodsmentioning

confidence: 99%

Section: Hrct Measurementsmentioning

confidence: 96%

Oesophageal diameter is associated with severity but not progression of systemic sclerosis‐associated interstitial lung disease

et al. 2018

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“…A study of 1043 subjects demonstrated that SSc patients with more gastrointestinal (GI) involvement/symptoms had a lower forced vital capacity (FVC) % predicted on pulmonary function tests (PFT), supporting the hypothesis that SSc GI and lung disease are associated [4]. Because microaspiration of refluxed gastric contents may play a central role in the initiation and progression of other forms of interstitial lung disease (ILD) including idiopathic ILD [5–8], we hypothesized that a dilated esophagus on HRCT may be associated with ILD in patients with SSc.…”

Section: Introductionmentioning

confidence: 99%

“…The present study includes a large cohort of clinically well-characterized patients with SSc and utilizes published ILD and state-of-the-art widest esophageal diameter (WED) scoring protocols. Because ILD is a leading cause of death in SSc, and esophageal dysmotility may contribute to ILD progression via microaspiration [5–8], it is important to characterize fully the association between esophageal dilation and both radiographic ILD and pulmonary function in SSc patients.…”

Section: Introductionmentioning

confidence: 99%

Esophageal dilatation and interstitial lung disease in systemic sclerosis: A cross-sectional study

Richardson

Agrawal

Lee

et al. 2016

Seminars in Arthritis and Rheumatism

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Objective A patulous esophagus on high-resolution computed tomography (HRCT) of the thorax is frequently observed in patients with systemic sclerosis (SSc). Microaspiration has been purported to play a role in the development and progression of SSc interstitial lung disease (ILD), but studies examining the role of microaspiration in SSc ILD have yielded conflicting results. This study was conducted to determine the association between esophageal diameter and SSc ILD. Methods A cross-sectional study of Northwestern Scleroderma Registry patients with available HRCT exams was conducted. The predictor variable was the widest esophageal diameter (WED) on HRCT, and the primary and secondary outcome variables were radiographic ILD and pulmonary function tests respectively. The degree of radiographic ILD was assessed using a semi-quantitative score adapted from published methods. Estimated regression coefficients adjusted for age, sex, race, body mass index, smoking; SSc disease subtype, serum autoantibodies, and disease duration; modified Rodnan skin score, proton pump inhibitor, and immune suppressant medication use and erythrocyte sedimentation rate were calculated. Results A total of 270 subjects were studied. In the adjusted analyses, there were positive associations between WED and total ILD score (β = 0.27; 95% CI: 0.09–0.41), fibrosis (β = 0.15; 95% CI: 0.07–0.23), and ground glass opacities (β = 0.12; 95% CI: 0.04–0.20); there were negative associations between WED and FVC % predicted (β = −0.42; 95% CI: −0.69 to −0.13), and adjusted DLCO % predicted (β = −0.45; 95% CI: − 0.80 to − 0.09) after adjusting for potential confounders. Conclusions Increasing esophageal diameter on HRCT in patients with SSc is associated with more severe radiographic ILD, lower lung volumes, and lower DLCO % predicted. Longitudinal studies are needed to determine if esophageal dilatation is associated with the incidence and/or progression of ILD in patients with SSc.

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“…Computed tomography and magnetic resonance imaging may have features of SSc, such as dilation of the esophagus, but are not diagnostic (36). Lastly, (18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET) provides robust and reproducible data for early metabolic response assessment in various malignancies (37), it has not yet been used for assessment of GIT disease in SSc.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Measuring response in the gastrointestinal tract in systemic sclerosis

Khanna

Nagaraja

Gladue

et al. 2013

Current Opinion in Rheumatology

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Purpose of review Gastrointestinal tract (GIT) involvement in systemic sclerosis (scleroderma, SSc) is the most common internal complication. This review discusses the outcome measures to measure GIT involvement in clinical care and trials. Recent findings Patient-reported outcome measures have been validated (UCLA SCTC GIT 2.0 and NIH PROMIS® scales) in SSc-GIT. Multiple objective measures are available to assess mucosal involvement and motility in GIT. However, these need to validated in SSc for trials. Summary GIT is a common cause of morbidity and has negative impact on quality of life in SSc. Recommendations are given for trial design and evaluation of GI involvement in SSc.

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Oesophageal dilatation on high-resolution CT chest in systemic sclerosis: What does it signify?

Abstract: Patients with oesophageal dilatation on HRCT chest had significantly lower diffusion capacity of carbon monoxide and higher peak PA pressures, which suggest that these patients tend to have more severe pulmonary vascular disease.

Cited by 17 publications

References 20 publications

Oesophageal diameter is associated with severity but not progression of systemic sclerosis‐associated interstitial lung disease

Oesophageal diameter is associated with severity but not progression of systemic sclerosis‐associated interstitial lung disease

Esophageal dilatation and interstitial lung disease in systemic sclerosis: A cross-sectional study

Measuring response in the gastrointestinal tract in systemic sclerosis

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