The term “esophagram” is slowly replacing the ambiguous term “barium swallow.” Note that an esophagram, which is designed to evaluate the pharyngeal and esophageal mucosa, is distinct from a “modified barium swallow,” which evaluates laryngotracheal aspiration and is usually performed in conjunction with a speech pathologist. At some institutions, an esophagram includes a complete evaluation of the pharynx, but at other institutions, a “cervical esophagram,” “pharyngoesophagram,” or “pharyngography” must be specifically requested.
Note that the nasopharynx is not evaluated with fluoroscopic techniques; cross-sectional imaging is required.
Pharyngoesophagram
A complete esophagram has three phases: full-column (single contrast), air-contrast (double contrast), and mucosal relief. To obtain full-column images, the patient is given a thin suspension of barium by mouth. The pharynx is best imaged in the standing position, with rapid cineradiography (four to six images per second) in several projections .
