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CT of the Normal Esophagus to Define the Normal Air Column and Its Extent and Distribution

Dean E. Schraufnagel1, Jon C. Michel1, Todd J. Sheppard1,2, Patricia Cole Saffold1 and George T. Kondos3

1 Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, M/C 719, University of Illinois at Chicago, 840 S Wood St., Chicago, IL 60612-7323.
2 Present address: Division of Pulmonary Medicine, Rochester General Hospital, Rochester, NY.
3 Section of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL.


Figure 1
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  		Fig. 1 —CT scan shows measurement taken at 52% of length of esophagus in 56-year-old woman. Greatest linear distance of air column of esophagus was measured. Measuring line could not touch tissue. If esophageal air column was folded, only greatest distance between its walls was recorded. Scale is in millimeters.

 

Figure 2
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  		Fig. 2A —Lumina of air columns going down thorax in 56-year-old woman, same patient as in Figure 1. This set of CT scans shows landmarks for distance down esophagus. At 3% or just after entering thorax. Frequently, this area of esophagus is closed. Median air column width for all segments for first 34% of esophageal length was 0.

 

Figure 3
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  		Fig. 2B —Lumina of air columns going down thorax in 56-year-old woman, same patient as in Figure 1. This set of CT scans shows landmarks for distance down esophagus. At 39%, which is about level of carina. Top of aortic arch is about 30% of thoracic esophageal distance.

 

Figure 4
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  		Fig. 2C —Lumina of air columns going down thorax in 56-year-old woman, same patient as in Figure 1. This set of CT scans shows landmarks for distance down esophagus. Image at 63% down esophagus, which cuts through upper part of heart. From this point down to about 75% (about middle of ventricles), esophageal air column is often closed and usually < 10 mm; median column size was 0.

 

Figure 5
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  		Fig. 2D —Lumina of air columns going down thorax in 56-year-old woman, same patient as in Figure 1. This set of CT scans shows landmarks for distance down esophagus. Image at 86% of thoracic esophageal course, often corresponding to first appearance of diaphragm. Esophagus in this region is typically open and has largest air column dimensions. Its median air column width is > 3 mm.

 

Figure 6
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  		Fig. 2E —Lumina of air columns going down thorax in 56-year-old woman, same patient as in Figure 1. This set of CT scans shows landmarks for distance down esophagus. Image at 97% of esophageal course through thorax. Lower esophageal sphincter is almost always closed. Lower esophageal sphincter is usually in last two sections of chest and first section of abdomen.

 

Figure 7
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  		Fig. 3 —Graph shows means of interpolated esophageal dimensions for each section along length of esophagus.

 

Figure 8
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  		Fig. 4A —Graphs show esophageal lumina by sex. Men (A) had larger esophageal dimensions in area inferior in relation to heart than women (B).

 

Figure 9
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  		Fig. 4B —Graphs show esophageal lumina by sex. Men (A) had larger esophageal dimensions in area inferior in relation to heart than women (B).

 

Figure 10
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  		Fig. 5 —Graph shows frequency of air columns with dimensions greater than 10 mm in progressive sections going down thorax. Highest possible denominator at each section is 110.

 

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