Objective To investigate the imaging features of megaesophagus, and to improve the understanding of the disease. Methods The imaging data of a patient with megaesophagus was analyzed retrospectively and the literature review was performed. Results Cervical MRI scan showed esophageal dilatation localized behind trachea and anterior to vertebral body, T1WI showed hypointense and T2WI showed hypointense. Neck and lung CT scan examination showed a significant expansion of the whole esophagus. The maxium diameter of expanding esophagus was about 7 cm. A lot of chyme were detected, and no obvious cardiac mass was found. The adjacent trachea and mediastinum were compressed, tracheobronchial stenosis was precence. The contents of the mild expanding stomach could be seen. The barium showed punctate high density in the dilated esophagus and stomach on abdominal CT after taking barium meal. On esophageal barium meal examination, the whole esophagus showed marked uneven dilation and segmental cystic changes. The barium passed through the esophagus slowly. There were many wide air-liquid levels, food retention could be seen in the esophagus. The peristaltic wave of esophagus was soft, and the mucosal pattern was not clear but thickening. Conclusion The imaging features of megaesophagus are specific, and are helpful in making diagnosis.%目的 通过探讨巨食管症的影像表现,以提高对巨食管症的认识.方法 回顾性分析1例巨食管症病人的影像资料并进行文献复习.结果 病人颈椎MRI平扫检查提示气管后方椎体前方食管扩张,T1WI呈低信号,T2WI呈低信号.颈部、肺部CT平扫检查示食管全程显著扩张,扩张最宽处直径约7 cm,内见大量食糜,贲门部未见明显肿块,相邻气管及纵隔内结构受压推移,气管支气管狭窄,胃内见内容物,扩张尚可.服用钡餐后,腹部平扫CT示扩张的食管、胃内均见点状高密度钡剂显影.食管钡餐造影检查提示食管全程显著不均匀迂曲扩张,呈节段性囊样改变,钡剂下行缓慢,食管内见较多食物潴留及多个宽大液平,蠕动尚柔和,黏膜纹增粗,局部显示不清.结论 巨食管症的影像表现具有特异性,熟悉巨食管症的影像表现有助于本病的诊断.
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