Radiology, Vol 153, 333-335, Copyright © 1984 by Radiological Society of North America
The reticular pattern as a radiographic sign of the Barrett esophagus: an assessment
ME Vincent, AH Robbins, SJ Spechler, R Schwartz, WG Doos and EM Schimmel
A two-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 barium esophagrams done at our
institution during a 3 1/2 month 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. Twelve of these patients
underwent careful esophageal mapping biopsies: the pattern was in squamous
mucosa with ulceration in two, in columnar epithelium with ulceration in
six, and in columnar epithelium without ulceration in four. In the group of
314 unselected patients who had double-contrast examinations, the reticular
pattern was found in 26 (8%). Thirteen of the 26 had had endoscopy and
biopsy: the site of the pattern was located in a squamous carcinoma in one,
in squamous epithelium adjacent to squamous carcinoma in three, in squamous
epithelium with esophagitis in five (two of whom had columnar mucosa
distally), in normal squamous mucosa in one, and in columnar epithelium
with esophagitis in three. The reticular pattern is a strong indicator of
important esophageal disease, but is not specific for Barrett esophagus.
