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CT Findings in Patients with Esophagitis

¹ All authors: Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.

OBJECTIVE. The purpose of our study was to determine the CT findings in patients with esophagitis.

MATERIALS AND METHODS. A search of medical and radiology files revealed 29 patients with esophagitis in whom thoracic CT was performed within 1 month of the diagnosis. The CT scans were reviewed retrospectively for esophageal wall thickening, a target sign, or other abnormalities. The thickness of the esophageal wall was also measured on CT in these 29 patients and compared with a control group of 85 patients.

RESULTS. We found that 16 patients (55%) with esophagitis had abnormal findings on CT, including a thickened esophageal wall (using 5 mm as the threshold for wall thickening) in all 16 (55%) and a target sign in five (17%). The overall mean esophageal wall thickness was 4.7 mm (standard deviation [SD], 2 mm; 95% confidence interval [CI], 0.7-8.7 mm) in patients with esophagitis versus a mean wall thickness of 2.9 mm (SD, 0.8 mm; 95% CI, 1.3-4.5 mm) in controls (p <.001). Using the same 5-mm threshold for wall thickening, we found that only three (4%) of 85 controls had a thickened esophageal wall on CT.

CONCLUSION. The majority of patients with esophagitis had abnormalities on CT, including a thickened esophageal wall (5 mm) in 55% and a target sign in 17%. Although barium studies and endoscopy are more sensitive modalities for detecting this condition, the CT finding of a relatively long segment of circumferential esophageal wall thickening, with or without a target sign, should suggest the diagnosis of esophagitis in the proper clinical setting.

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