Turkish Thoracic Journal
Original Article

Esophageal Dilatation as a Predictor of Systemic Sclerosis in Patients with Interstitial Lung Disease


Department of Radiology, Hospital Garcia de Orta, Almada, Portugal

Turk Thorac J 2021; 22: 231-236
DOI: 10.5152/TurkThoracJ.2021.19162
Read: 100 Downloads: 16 Published: 03 June 2021

OBJECTIVE: To determine the predictive value of esophageal dilatation as observed in high-resolution computed tomography (HRCT) for the diagnosis of systemic sclerosis (SSc) in patients with interstitial lung disease (ILD).

METHODS: Our sample consisted of patients diagnosed with SSc and proven interstitial lung involvement with available HRCT exams (n = 20). Individuals with other forms of rheumatic ILD were included as a control group (n = 20). Two blinded radiologists independently reviewed the images for the presence of esophageal dilatation, measured at 3 different levels. Interobserver agreement was tested with Lin’s concordance correlation coefficient (CCC). Independent t-test was used to compare maximum esophageal diameters between groups. Friedman's test was used to evaluate differences between the 3-level measurements. Receiver operating characteristic analysis was performed.

RESULTS: There was a substantial correlation between both readers (CCC = 0.9802-0.9919). Esophageal dilatation was significantly associated with SSc (P = .0012). The optimal calculated cut-off value to differentiate SSc from other ILDs was 18.5 mm (sensitivity and specificity of 70 and 90%, respectively; area under the curve 0.819), measured 1 cm above the diaphragmatic hiatus.

CONCLUSION: HRCT may have a discriminative role in the presence of both ILD and esophageal dilatation for the diagnosis of SSc. Our results suggest that a cut-off value for the esophageal diameter of 18.5 mm might propose the diagnosis of SSc with reasonable confidence.

Cite this article as: de Figueiredo AFSD, Costa J, Matos A, Ramalho M. Esophageal dilatation as a predictor of systemic sclerosis in patients with interstitial lung disease. Turk Thorac J. 2021; 22(3): 231-236.

EISSN 2149-2530