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Acute radiation esophagitis: radiographic findings
L A Collazzo1, M S Levine, S E Rubesin
1Department of Radiology, Hospital of the University of Pennslyvania, Philadelphia 19104, USA.
AJR. American Journal of Roentgenology
|October 6, 1997
Summary
Double-contrast esophagograms can identify granular mucosa and ulcers in patients with acute radiation esophagitis. These findings, along with esophageal narrowing, suggest the diagnosis within a radiation portal.
Area of Science:
- Radiology
- Gastroenterology
- Oncology
Background:
- Acute radiation esophagitis is a common side effect of thoracic radiation therapy.
- Esophagography is frequently used to evaluate symptoms such as odynophagia and dysphagia.
Purpose of the Study:
- To assess radiographic findings of acute radiation esophagitis using double- and single-contrast esophagograms.
- To specifically evaluate for the presence of granular mucosa in affected patients.
Main Methods:
- Retrospective review of 13 patients with acute radiation esophagitis.
- Analysis of double-contrast (n=8) and single-contrast (n=5) esophagograms.
- Barium studies performed 13-87 days post-radiation therapy initiation.
Main Results:
- Double-contrast esophagography revealed granular mucosa (50%) and ulcers (37%) in patients.
- Esophageal narrowing within the radiation portal was associated with these findings.
- Single-contrast studies showed narrowing, ulceration, and thickened folds.
- Three of four patients developed radiation strictures on follow-up.
Conclusions:
- Double-contrast esophagography can demonstrate esophageal narrowing, ulcers, or granular mucosa in acute radiation esophagitis.
- These findings within a known radiation portal are suggestive of the diagnosis.
- Radiographic findings aid in diagnosing radiation-induced esophageal injury.