Establishing normal values for pediatric esophageal diameter on fluoroscopy

Area of Science:

• Pediatric Radiology
• Gastroenterology
• Medical Imaging

Background:

• Standardized esophageal diameter values for fluoroscopy are currently lacking.
• This deficiency hinders the diagnosis of subtle esophageal narrowing in pediatric patients.

Purpose of the Study:

• To establish age-based normal values for esophageal diameter in children aged 1 to 17 years.
• To provide quantitative metrics for interpreting fluoroscopic examinations of the pediatric esophagus.

Main Methods:

• Retrospective analysis of 160 pediatric patients with normal upper gastrointestinal fluoroscopy and biopsy.
• Esophageal diameters measured at three locations and two projections by three readers.
• Statistical analysis including intra-class correlation coefficients and Student's t-tests.

Main Results:

• Excellent inter-reader measurement agreement (ICCs > 0.75) was achieved.
• A linear increase in esophageal diameter with age was observed.
• Mean esophageal diameters ranged from 11-21 mm (anteroposterior) and 8-17 mm (lateral) across all ages.

Conclusions:

• Established normal esophageal diameter ranges provide quantitative metrics for pediatric fluoroscopy interpretation.
• These new reference values may facilitate earlier diagnosis of esophageal pathology in children.