Computed Tomography of the Esophagus in Scleroderma and Lung Disease

Takekoshi, Daisuke; Arami, Shiva; Sheppard, Todd; Cole-Saffold, Patricia; Michel, J; Kondos, George T.; Schraufnagel, Dean E.

doi:10.1620/tjem.237.345

Cited by 15 publications

(9 citation statements)

References 17 publications

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“…Oesophageal diameter was measured as the maximum coronal diameter from thoracic inlet to oesophageal hiatus . In a previous study of normal volunteers, maximal oesophageal diameter (defined as the largest linear measurement of oesophageal air) was 9.7 mm (95%CI: 6.9 to 14.1) . Additional measurements included the presence of a hiatal hernia (oesophageal hiatus >1.5 cm and/or gastric structures above the hiatus), tracheal debris (dependent increased attenuation) and mucoid impaction (distal airways completely occluded by presumed mucous).…”

Section: Methodsmentioning

confidence: 99%

Oesophageal diameter is associated with severity but not progression of systemic sclerosis‐associated interstitial lung disease

et al. 2018

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Section: Methodsmentioning

confidence: 99%

Oesophageal diameter is associated with severity but not progression of systemic sclerosis‐associated interstitial lung disease

et al. 2018

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“…A total score of 30 was allocated for five types of lung lesions including bronchiectasis (9 points), bronchiolitis (6 points), cavity (9 points), nodule (3 points), and consolidation (3 points) depending on severity of lung lesions. Maximum diameter of esophagus (MDE) was measured on axial Chest CT images (5mm slice), and the longest distance of the esophageal air was measured without touching the wall as reported in a prior study [ 15 ]. We defined radiologically severe disease as CT score≧10 and milder disease as CT score<10.…”

Section: Methodsmentioning

confidence: 99%

Possible relationship between esophageal dilatation and severity of M. abscessus pulmonary disease

et al. 2021

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Objectives Recently, incidence of Mycobacterium abscessus (Mab) pulmonary disease (Mab-PD) is increasing worldwide. We aimed to identify factors associated with severity of Mycobacterium abscessus (Mab) pulmonary disease (Mab-PD). Methods All patients diagnosed as Mab-PD based on the official ATS/IDSA statement between 2017 January 1 and 2021 July 31 were included (n = 13). We reviewed medical records, bacteriological and laboratory data of the patients. Severity of lung lesions and esophageal diameters in chest CT were quantitatively evaluated. Gaffky score in the sputum was used as airway mycobacterial burden. We explored the factors associated with high CT score and high Gaffky score. Results Maximum diameter of esophagus (MDE) in severe disease (CT score≧10) was greater than that in milder disease (CT score<10) (18.0±7.9mm, 9.3±3.1mm, respectively, p = 0.01), and MDE was well correlated with CT score (R = 0.69, p = 0.007). MDE in high mycobacterial burden group (Gaffky score ≧5) tended to be greater than that in low mycobacterial burden group (Gaffky score <5) (16.1±6.8mm, 10.1±5.5mm, respectively, p = 0.12), and MDE was well correlated with Gaffky score (R = 0.68, p = 0.009). Lung lesions were bilateral and predominant in middle or lower lobes. Conclusions Esophageal dilatation was correlated with severity of Mab-PD and airway mycobacterial burden. Gastroesophageal reflux might be associated with Mab disease progression.

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“…The diameter of the diseased esophagus is significantly related to the degree of pulmonary fibrosis, and esophageal dilatation causes atelectasis and aggravates pulmonary fibrosis [ 14 , 15 , 17 ]. However, other authors suggest that pulmonary fibrosis leads to increased lung ventilation and downward movement of the diaphragm and that the use of bronchodilators causes the esophagus to dilate [ 2 , 32 ]. It is not clear whether there is a causal relationship between lung disease and esophageal motility disorders in patients with SSc or whether simultaneous involvement of these organ systems is a manifestation of advanced disease.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Esophageal Dysfunction in Systemic Sclerosis: An Update

Yan

et al. 2021

Rheumatol Ther

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Esophageal motility disorders are prevalent in 90% of patients with systemic sclerosis [scleroderma (SSc)], with an increased mortality rate in patients with severe esophageal involvement. Esophageal smooth muscle damage caused by ischemia, nerve damage, and inflammatory factors may be responsible for discomfort and various complications in these patients. The clinical manifestations are diverse. Most hospitals still use traditional esophageal manometry and 24-h pH monitoring to diagnose esophageal function in patients with SSc. The aim of this review article is to provide an overview of SSc-related esophageal motility disorders and related research progress, including the pathogenesis and clinical features of these disorders and the progress made in endoscopic diagnosis. We also discuss the possible pathogenesis and potential therapeutic targets.

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Computed Tomography of the Esophagus in Scleroderma and Lung Disease

Cited by 15 publications

References 17 publications

Oesophageal diameter is associated with severity but not progression of systemic sclerosis‐associated interstitial lung disease

Oesophageal diameter is associated with severity but not progression of systemic sclerosis‐associated interstitial lung disease

Possible relationship between esophageal dilatation and severity of M. abscessus pulmonary disease

Esophageal Dysfunction in Systemic Sclerosis: An Update

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