CT findings in patients with esophagitis

OBJECTIVE. The purpose of our study was to determine the CT findings in pat ients 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 t he esophageal wall was also measured on CT in these 29 patients and compare d with a control group of 85 patients. RESULTS. We found that 16 patients (55%) with esophagitis had abnormal find ings on CT, including a thickened esophageal wall (using 5 mm as the thresh old for wall thickening) in all 16 (55%) and a target sign in five (17%). T he overall mean esophageal wall thickness was 4.7 mm (standard deviation [S D], 2 mm; 95% confidence interval [CI], 0.7-8.7 mm) in patients with esopha gitis versus a mean wall thickness of 2.9 mm (SD, 0.8 mm; 95% CI, 1.3-4.5 m m) in controls (p < .001). Using the same 5-mm threshold for wall thickenin g, 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 (<greater than or equal to>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, wit h or without a target sign, should suggest the diagnosis of esophagitis in the proper clinical setting.