Sixty-seven patients with endoscopically proved esophagitis and 25 patients who had no esophageal disease were examined by double-contrast esophagography, followed by a single-contrast examination. The radiographs were evaluated separately and as a combined examination technique by three independent radiologists in a blind analysis. The respective sensitivities were 77% for the single-contrast examination, 80% for the double-contrast examination, and 88% for the combined examination method with no significant statistical difference (P = 0.05). The sensitivity increased for all methods with an increased severity of esophagitis. False positives more frequently occurred with double-contrast radiography, leading to similar accuracy rates for all methods (74% to 77%). The double-contrast examination technique showed an advantage over single-contrast radiography only if a granular pattern and erosions were the only radiographically detectible features of esophagitis. The use of the combined examination technique is recommended.
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