Radiological evaluation of dysphagia.

Radiological examination evaluates both structural and functional abnormalities of the esophagus in patients with dysphagia. Combined with the clinical history, the radiological results can guide the clinician to a specific diagnosis, such as carcinoma or stricture, or to additional studies, such as endoscopy or esophageal manometry. Based on cost and diagnostic efficacy, the radiological method, compared with endoscopy, is most useful as the initial screening examination in patients with dysphagia (Table 2). Its major limitations are poor detection of mild cases of esophagitis and occasional lack of specificity in diagnosing esophageal motor dysfunction. To achieve these results, however, effective radiological evaluation of the esophagus requires the meticulous use of a combination of examining techniques.