Cross-Sectional Imaging of the Hypopharynx and Esophagus (original) (raw)

Medical Radiology, 2004

Abstract

In most cases, imaging of the hypopharynx and esophagus is performed in patients with swallowing disorders (Czerny and Formanek 2000; Schmalfuss 2002). The aetiology of swallowing disorders can be attributed to different entities, either congenital or acquired. In the pharynx, malignant tumours primarily cause swallowing disorders (Becker et al. 1998; Czerny and Formanek 2000). In the esophagus, swallowing disorders are often due to tumours, inflammatory strictures in gastro-esophageal reflux disease, or achalasia, and also may be due to either benign or malignant tumours. In most cases, the first choice for imaging evaluation is a double-contrast pharyngoesophagogram, which depicts nicely the morphology and extent of mucosal lesions. However, radiography (and endoscopy) are not suited to delineate the extramucosal tumour spread (into lymph nodes and adjacent organs) or abnormalities of the mediastinum in non-neoplastic diseases, such as Boerhaave syndrome or fistulas. In these patients, contrast-enhanced CT or MRI play an important diagnostic role in therapeutic management (Helmberger et al. 1996). Positron emission tomography (PET) may also be used if a malignant process is to be staged pre-therapeutically (Flamen et al. 2000; Junginger et al. 2002). The imaging techniques and pathologies of the hypopharynx and the esophagus differ, and therefore, these techniques and pathologies will be described separately.

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