Mariano Sturla MD, Presenter: Nothing to Disclose

Alberto Cristian Seehaus MD, Abstract Co-Author: Nothing to Disclose

Jorge Alberto Ocantos MD, Abstract Co-Author: Nothing to Disclose

Demetrio Cavadas MD, Abstract Co-Author: Nothing to Disclose

Ricardo Daniel Garcia-Monaco MD, Abstract Co-Author: Nothing to Disclose

Present a new CT technique, using air to distend the esophagus, providing better characterization of the esophageal wall.

24 patients (45y – 67y) with clinical or radiological suspicion of esophageal cancer were examined with PN-CT. To achieve esophageal distension a 14F Foley tube was introduced TRANS-NASALLY and settled right below the cricopharyngeal muscles, under local spray anaesthesia. Correct location was confirmed by CT scan. We used 0.7-second single-detector-row spiral CT scanner. Acquisition included the area between C6 and L1 (inferior hepatic contour). Scan direction was craniocaudal and parameters were 3mm collimation, 1.5 reconstruction index, 120 Kv, 200mAseg and pich 1. A continuous airflow (20 ml/sec, starting 3sec before CT slice acquisition) was supplied. Airflow was sustained during the acquisition for 25 to 30 seconds. Multiplanar, 3D and virtual endoscopy reconstructions were performed in all patients.

Significant distension of the esophagus (2 cm or more of diameter) including gastro-esophagic transition zone was achieved in all patients. Esophageal lumen was visible in all its extension. In 23/24 patients mural thickening (3mm or more) was identified and measured. All lesions where characterized in size, shape and its location. The other sowed a polyp in the lower third of the esophagus. In 3/24 mural thickening were compromising the gastro-esophagic transition zone. Patients showed no complications or adverse effects, except one case of chest discomfort during the examination.

PN-CT proved to be a safe, useful and feasible technique for identification of normal and pathologic esophageal mural thickening.

This technique permits to identify clearly esophageal mural thickening including difficult areas such as the gastro-esophagic transition zone (in lesions extending to the stomach).

Sturla, M, Seehaus, A, Ocantos, J, Cavadas, D, Garcia-Monaco, R, Pneumo Esophageal CT (Pn-CT): New Technique for Characterization of Esophageal Cancer.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4432833.html