Levine M S, Kressel H Y, Caroline D F, Laufer I, Herlinger H, Thompson J J
Radiology. 1983 Jun;147(3):663-7. doi: 10.1148/radiology.147.3.6844601.
Barrett esophagus is an acquired condition with progressive columnar metaplasia of the esophagus due to chronic reflux esophagitis. The premalignant nature of this entity is well recognized. However, radiologic diagnosis has been limited by the nonspecificity of findings associated with the condition. We recently reviewed 29 cases of pathologically proved Barrett esophagus. Radiologic examinations revealed hiatal hernias, gastroesophageal reflux, esophagitis, and strictures. None of these findings are diagnostic of Barrett esophagus. In seven cases, however, double-contrast radiography also revealed a delicate reticular pattern in the esophagus. In all but one case, there was an adjacent stricture, and this reticular appearance extended distally a short but variable distance from the stricture. To our knowledge, this unusual reticular pattern has not been described previously, and it represents a valuable radiologic sign of Barrett esophagus. The etiology of this finding is uncertain, but correlation with the gross surgical specimen in one case suggests that it results specifically from areas of "villous" metaplasia in Barrett epithelium. This delicate reticular pattern appears to be a specific radiologic criterion for the diagnosis of Barrett esophagus.
巴雷特食管是一种后天性疾病，由于慢性反流性食管炎导致食管出现进行性柱状上皮化生。该病变的癌前性质已得到充分认识。然而，放射学诊断一直受到与该疾病相关的非特异性表现的限制。我们最近回顾了29例经病理证实的巴雷特食管病例。放射学检查发现有食管裂孔疝、胃食管反流、食管炎和狭窄。这些表现均不能诊断巴雷特食管。然而，在7例病例中，双重对比造影还显示食管内有细微的网状形态。除1例病例外，其余所有病例均有相邻狭窄，且这种网状形态从狭窄处向远端延伸一小段但长度不一的距离。据我们所知，这种不寻常的网状形态此前尚未见报道，它是巴雷特食管的一个有价值的放射学征象。这一表现的病因尚不确定，但在1例病例中与大体手术标本的相关性表明，它具体是由巴雷特上皮中的“绒毛状”化生区域导致的。这种细微的网状形态似乎是诊断巴雷特食管的一个特异性放射学标准。
