Microdissection of Human Esophagogastric Junction Wall with Phase-contrast X-ray CT Imaging.

Jianfa Zhang,Runhua Lin,Guanyun Peng,Min Su,Guangzhao Zhou,Dongping Tian

doi:10.1038/srep13831

Abstract

Phase-contrast x-ray imaging using an x-ray interferometer has great potential to reveal the structures inside soft tissues, because the sensitivity of this method to hydrogen, carbon, nitrogen, and oxygen is about 1000 times higher than that of the absorption-contrast x-ray method. In this study, we used phase-contrast X-ray CT to investigate human resected esophagogastric junction. This technology revealed the three-layer structure of the esophagogastric junction wall—mucous, submucosa and muscular layers. The mucous and muscular layers were clearly separated by a loose submucosa layer with a honeycomb appearance. The shape of the mucous and muscular layers was intact. The boundary between the mucous and submucosa layers was distinct, as was the border of the muscular and submucosa layers. The surface of the esophagogastric junction was displayed clearly through 3D reconstruction. The technology might be helpful in the diagnosis of esophagogastric junction lesion, especially for the early adenocarcinoma.

Highlights

The esophagogastric junction (OGJ) is located between the oesophagus and the stomach
These relaxations are known as transient lower oesophageal sphincter relaxations[6]
The prognosis of patients with adenocarcinoma of esophagogastric junction (AEG) has not been improved, because of the result of major patients being diagnosed at an advanced stage[7]

Summary

Introduction

The esophagogastric junction (OGJ) is located between the oesophagus and the stomach. It is a highly specialized anatomical region that is often difficult to understand[1]. The esophagogastric junction is important that backflow of stomach secretions into the oesophagus is controlled at the OGJ opening only transiently to allow passage of the swallowed food into the stomach. The intrinsic muscles of the distal oesophagus and the sling fibers of the proximal stomach make up the internal mechanism structures of the LOS. The sphincter relaxes in response to a swallow and this usually precedes the arrival of a contraction wave travelling down the oesophagus. The esophagogastric junction examination mainly depends on these methods such as CT8–11, magnetic resonance imaging (MRI)[10,12], endoscopy[13] and gas-barium doublecontrast X-ray gastrointestinalgraphy[14]

Methods

Results

Conclusion