Radiographic and endoscopic sensitivity in detecting lower esophageal mucosal ring

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Lower esophageal mucosal ring is a condition affecting the esophagus.
• Accurate detection is crucial for diagnosis and management of dysphagia.

Purpose of the Study:

• To compare the diagnostic sensitivity of radiography and endoscopy for lower esophageal mucosal rings.
• To evaluate factors influencing detection rates for each modality.

Main Methods:

• Retrospective analysis of 60 patients with lower esophageal mucosal rings.
• Comparison of barium esophagram (prone full-column and double-contrast techniques) with endoscopy.
• Correlation of detection rates with ring caliber and endoscope size.

Main Results:

• Barium esophagram detected 95% of rings; double-contrast technique detected 46%.
• Endoscopy detected 58% of rings, with sensitivity decreasing for larger rings (≤13mm: 82%, 14-19mm: 54%, ≥20mm: 25%).
• Dysphagia was more common in patients with endoscopically undetected rings; larger endoscopes improved detection rates.

Conclusions:

• Radiography, particularly barium esophagram, is more sensitive than endoscopy for detecting lower esophageal mucosal rings.
• Initial radiographic examination is recommended for patients with dysphagia and suspected esophageal narrowing.