Postcricoid Region and Cervical Esophagus: Normal Appearance at CT and MR Imaging
Abstract
PURPOSE: To establish the normal variations of the postcricoid portion of the hypopharynx, esophageal verge, and cervical esophagus, as seen on computed tomographic (CT) and magnetic resonance (MR) images.
MATERIALS AND METHODS: One hundred twenty-one CT and 92 MR images were reviewed. Diameter and wall thickness were measured at multiple levels. Depiction of the layers of the musculature and adjacent fat planes was evaluated. The frequency and size of the tracheoesophageal lymph nodes were noted.
RESULTS: An esophageal anteroposterior diameter greater than 16 mm and lateral diameter greater than 24 mm were considered abnormal. The average wall thickness was 4.8 mm laterally and 3.8 mm posteriorly. Demonstration of the intramural fat planes of the postcricoid region decreased from the upper to the lower region of the cricoid cartilage. The ability to separate the esophageal wall from the trachea was highest at the esophageal verge and declined markedly more distally. The tracheoesophageal groove nodes were seen more often on the right (mean size [± SD], 4.5 mm ± 2.2).
CONCLUSION: Knowledge of the normal appearance and variations of the postcricoid region and cervical esophagus is essential in detecting abnormalities in these areas.
References
- 1 Quint LE, Glazer CM, Orringer MB. Esophageal imaging by MR and CT: study of normal anatomy and neoplasms. Radiology 1985; 156:727-731. Link, Google Scholar
- 2 Saleh EM, Mancuso AA, Stringer SP. Relative roles of computed tomography and endoscopy for determining the inferior extent of the pyriform sinus carcinoma: correlative histopathologic study. Head Neck 1993; 15:44-52. Crossref, Medline, Google Scholar
- 3 Halber MD, Daffner RH, Thompson WM. CT of the esophagus. I. Normal appearance. AJR 1979; 133:1047-1050. Google Scholar
- 4 Goldwin RL, Heitzman ER, Proto AV. Computed tomography of the mediastinum. Radiology 1977; 124:235-241. Link, Google Scholar
- 5 Moss AA, Schnyder P, Thoeni RF, Margulis AR. Esophageal carcinoma: pretherapy staging by computed tomography. AJR 1981; 136:1051-1056. Crossref, Medline, Google Scholar
- 6 Picus D, Balfe DM, Koehler RE, Roper CL, Owen JW. Computed tomography in the staging of esophageal carcinoma. Radiology 1983; 146:433-438. Link, Google Scholar
- 7 Glazer GM, Gross BH, Quint LE, Francis IR, Bookastein FL, Orringer MB. Normal mediastinal lymph nodes: number and size according to American Thoracic Society mapping. AJR 1985; 144:261-265. Crossref, Medline, Google Scholar
