The reticular pattern as a radiographic sign of the Barrett esophagus: an assessment.

Abstract

A 2-part retrospective study was conducted to assess the value of a reticular pattern as a sign of columnar-lined esophagus. Radiographic, endoscopic and histologic findings were reviewed in 124 patients with known Barrett esophagus; then all Ba esophagrams done at this institution during a 31/2 mo. period were reviewed and presence of a reticular pattern was correlated with available endoscopic and histologic data. In patients with known Barrett esophagus, the reticular pattern was found in 26% of double-contrast examinations. Of these patients, 12 underwent careful esophageal mapping biopsies: the pattern was in squamous mucosa with ulceration in 2, in columnar epithelium with ulceration in 6, and in columnar epithelium without ulceration in 4. In the group of 314 unselected patients who had double-contrast examinations, the reticular pattern was found in 26 (8%). Of the 26, 13 had endoscopy and biopsy: the site of the pattern was located in a squamous carcinoma in 1, in squamous epithelium adjacent to squamous carcinoma in 3, in squamous epithelium with esophagitis in 5 (2 of whom had columnar mucosa distally), in normal squamous mucosa in 1, and in columnar epithelium with esophagitis in 3. The reticular pattern is a strong indicator of important esophageal disease, but is not specific for Barrett esophagus.