title: Clinical investigation on application of water swallowing to MR esophagography.
abstract: OBJECTIVE
  To verify the clinical outcomes of applying water swallowing to MR esophagography.
  
  
  METHODS
  Thirty patients confirmed postoperatively or histopathologically with thoracic esophageal carcinoma by endoscopic biopsy and 10 healthy volunteers with normal esophagus underwent respectively conventional magnetic resonance imaging (MRI) detection and water swallowing MR esophagography. Of those patients, 4 underwent second examination after radiotherapy. Assessment on imaging effects of MR esophagography was performed. Assessment on definition on MR esophagography of the tumor in both upper and lower ends, specific localization, tumor size finally measured, coincidence with the gross pathologic types and tumor staging were respectively performed by comparison with conventional MRI. Additionally, we evaluated the outcomes of radiotherapy by comparing the previous MR esophagography with the second one with interventional technique.
  
  
  RESULTS
  Of the total 44 images of MR esophagography, 97.7% (43/44) were in high resolution by sagittal view and 81.8% (36/44) by cross-section. 93.3% (56/60) of the MR esophagography were clearly defined with the neoplastic lesion ends in the 30 patients with thoracic esophageal carcinoma, compared with 11.7% (7/60) by conventional MRI. The results were totally different in statistics (P<0.005). Preoperative conventional MRI detection of the 22 cases in 25 undergone radical resection suggested vague diameter of the primary tumor and impossibly identified it at middle-lower thoracic esophagus in 5, and even failed to confirm gross pathologic types in 19 cases. Yet, MR esophagography with water swallowing represented accurate tumor length (graded as excellent) in 88% (22/25), localization in 100% (25/25), exact gross pathologic types in 88% (22/25), and accuracy for tumor staging in 80.8% (21/26) compared to 92.3% (24/26) by conventional MRI. Therapeutic effects achieved in 4 patients with radiotherapy.
  
  
  CONCLUSIONS
  MR esophagography with water swallowing makes optimal esophagram and is of great value in the preoperative diagnosis of thoracic esophageal cancer and assessment of the radiotherapy effects for patients with such neoplasm, which may serve as an alternative for conventional MRI.
authors.affiliation: Department of Radiology, Tongling People's Hospital, Bijiashan Road 468, Tongling 244000, Anhui, China. zjpmri@163.com
authors.forename: Jinping
authors.initials: J
authors.lastname: Zhang
authors.forename: Weijian
authors.initials: W
authors.lastname: Hu
authors.forename: Lin
authors.initials: L
authors.lastname: Zang
authors.forename: Yibin
authors.initials: Y
authors.lastname: Yao
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Tang
authors.forename: Zhen
authors.initials: Z
authors.lastname: Qian
authors.forename: Ping
authors.initials: P
authors.lastname: Gao
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Wu
authors.forename: Shijian
authors.initials: S
authors.lastname: Li
authors.forename: Zhenlan
authors.initials: Z
authors.lastname: Xie
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Yuan
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000473:pathology*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014867:Water / Q000008:administration & dosage*
chemical_list: D003287:Contrast Media; D014867:Water