E1414. Reviving the Art of Performing an Upper Gastrointestinal Fluoroscopic Examination in Adult Patients
  1. Jonathan Revels; University of New Mexico
  2. Shamus Moran; University of Washington
  3. Margarita Revzin; Yale University
  4. Douglas Katz; NYU Winthrop Hospital
  5. Mariam Moshiri; University of Washington
The role of fluoroscopic imaging in today’s radiology practice is complementary to computed tomography (CT) and magnetic resonance imaging (MRI), and can aid in the evaluation of pathological abnormalities (neoplasms, ulcers, perforations/post-operative leaks, etc.), as well as assess physiological function in the setting of motility disorders. This educational exhibit will familiarize the radiologist with imaging of normal upper gastrointestinal (UGI) anatomy and anatomic variants on single and double contrast examinations, and review the fluoroscopic findings of benign and malignant pathologies with emphasis on key differentiating features between these entities. Pitfalls and pathology mimics on UGI will also be discussed.

Educational Goals / Teaching Points
o Discuss proper patient positioning, contrast type, and imaging technique with diagrammatic representations o Familiarize the radiologist with imaging presentation of normal upper gastrointestinal (UGI) anatomy and anatomic variants on single- and double- contrast barium examinations o Review common and uncommon fluoroscopic findings of benign and malignant pathologies, and the key differentiating features o Discuss potential mimics and pitfall on UGI o Discuss the role of fluoroscopy in current radiology practice

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Outline: o Proper patient positioning, technique, contrast type, and imaging parameters in UGI fluoroscopy o Review the normal appearance of anatomy, anatomical variants (gastric diverticulum, redundant antrum and pylorus), and associated physiology o Double- and single-contrast imaging fluoroscopy techniques o Benign pathologies • Ulcers (acute and chronic, infectious, malignant, and perforated) • Gastritis (infectious, malignant, and inflammatory) • Abnormal physiology (delayed and rapid emptying) • Other (diverticulum, fistula, hernia, volvulus, bezoar, etc.) • Post-surgical stomach (gastric bypass, gastric banding, gastric resection) o Potential mimics

The UGI fluoroscopic examination has an ongoing key role in radiology practice that is complementary to CT and MRI. Having familiarity with proper imaging technique, normal anatomy, and the differing appearance of benign versus malignant pathologies will ensure radiologists provide a high quality interpretation of this examination.