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Thickening of the Stomach Wall on CT Scan
On CT scan, thinning of the stomach wall is not the same thing as gastric cancer. CT is not the gold standard when it comes to diagnosing this condition. MRI is better at detecting a wide range of tumors and is better suited for evaluating tumor-like masses. In this article, we discuss causes, MRI and endoscopic evaluation. We also discuss the differences between CT and MRI.
Antral thickening on CT scan is commonly misinterpreted as antral gastritis. There has never been a study that showed an association between antral wall thickness and Helicobacter Pylori infection. Previous studies that did not include a control group might have been misleading. Nonetheless, the findings from our case study are helpful in guiding diagnostic decision-making. In this case, the patient suffered from intermittent vomiting and diarrhea for two months.
Antropyloric pathology can be distinguished by CT scans. This characteristic can be used to distinguish between benign and malignant gastric thickening, even though it is not specific for gastric cancer. Besides identifying potential malignancy, the antrum wall thickness is also helpful in distinguishing between benign and malignant gastric diseases. The authors conclude that CT scans can help to identify gastric cancer earlier and improve patient treatment.
Antral wall thicknessening on CT scan may be segmental, symmetric, or diffuse. This type of thickening may be caused by cancer, inflammatory or infectious conditions, or bowel obstruction. The pattern of attenuation helps narrow down the differential diagnosis. When the thickening is symmetrical, it may be caused by an adenocarcinoma. This is not a reliable way to determine the cause of antral thickening in CT scan.
CT scans of the abdomen, especially those that include the fundus, can be helpful in diagnosing antral thickening. This type of imaging can also confirm the diagnosis. Endoscopic evaluation can be costly and can lead to complications. Endoscopic examination may be necessary if the patient has anterior wall thickness. This could delay treatment. In this case, a good evaluation of the wall thickness may help avoid unnecessary endoscopic examinations.
Multisegmental anatomic distribution
Moreover, this finding has important clinical implications. It is important to remember that the thicknesses of the gastrointestinal walls are normal in all organs, except the duodenum, the ileum and the transverse colon. It is possible to have cirrhosis if the thickness of the gastrointestinal wall is abnormal. However, it should be a sign that there are other causes.
Thickening of the antral wall is often the result of Helicobacter pylori infection, which is common in older Americans. This antral thickening is typically 1.5 to 2 cm in size. This anatomic pattern can also be caused by nonsteroidal antiinflammatory medications, perigastric inflammation processes, and chronicgranulomatosis. This anatomic feature is less common in lymphoma and metastatic diseases.
Barium studies and other radiographic techniques have been useful in evaluating the stomach’s thickness, but they are not able to accurately depict the gastric wall’s actual thickness. In the late 1970s and early 1980s, studies using conventional CT showed that this technique is better suited to more direct assessment of the gastric wall. However, CT cannot be used to distinguish between abnormal and normal wall thickening.
On CT scan, the anterior and posterior gastric walls were examined separately to determine multisegmental anatomic distributions of thickened stomach walls. A dissection of an 85-year-old woman revealed mild anatomical thickening in her antral wall. This leads to the pylorus. The anterior wall of the proximal gastric body was also thickened.
The median thickness of the antral wall was 4.6 +/-1. cm on MDCT. Antral thickening extended to the pylorus in this case study. While it was difficult to measure the antral thickness, the overall pattern of the gastric thickening was similar to that seen in MDCT scans. This study also showed the thin walls of the proximal and tertiary gastric bodies, as well as the pylorus.
To improve this analysis, the gastric wall structure can be stratified. We can measure the thickness of each layer using an anisotropic diffusion filtre and edge detection. Besides, the ratio of the different layers in the gastric wall can improve the accuracy of ultrasound diagnosis of gastric cancer. It can even increase the efficiency in gastric cancer screening.
The thickness of the stomach wall on a CT scan is a common complication of gastroesophageal reflux disease (GERD). The causes for this abnormality are still not completely understood, but the presence of abdominal soft tissue and abnormal tissue in the rectum may be a clue to the underlying problem. MRI and CT are not the only diagnostic tools for gastric wall thickening.
On CT sections, the gastric fundus can be seen posteriorly and is connected to the fundus below. Thickened stomach wall may lead to a prominent pseudotumor near the gastroesophageal junction. In this situation, additional distention is necessary to eliminate the pseudotumor. The stomach sweeps toward the right and is joined by the antrum to the duodenal bulb in the area of the gallbladder.
Endoscopic ultrasound or CT scans can show the thickness of the gastric wall. This should be done to rule out other causes of gastric cancer. Subepithelial and linitis-plastica are common causes of thickening in the gastric wall. Thickening may also occur in areas of the stomach containing stromal tumors or in the presence of ectopic pancreas.
An early sign of gastric cancer is an increase in the thickness of the gastric wall on a CT scan. Early detection of gastric cancer is the best way to determine its prognosis. A CT-detected thickening of the gastric wall of 1 cm or greater can be helpful in diagnosing gastric cancer. However, it is important to have an early biopsy or endoscopy done to determine the cause.
A second CT scan revealed a scalloped esophageal wall. Without contrast enhancement, these patches are indistinguishable from tumors. Other causes include long-term intubation and gastroesophageal reflux diseases. Candida infections can be a possibility in patients with immunodeficiency. On CT scans, Cytomegalovirus or herpes simplex virus may cause thickened stomach walls.
A 65-year-old man presented with diarrhea, epigastric pain, and abdominal fullness. A CT scan of the abdomen revealed an exophytic stomach tumor. A CT scan of the antrum and posterior wall of the stomach showed diffuse gastric wall thickening with sparse punctate calcification. Low-power photosmicrographs of the tumor showed abundant cytoplasmic neoplastic cell growth in the peritoneum.
Thickening of the stomach wall on CT scan can be an indication of many different pathologies. This condition may reflect infectious, inflammatory, ischaemic, or neoplastic pathologies. It could also be caused by benign strictures, which can cause the colon to collapse. Regardless of the underlying cause, patients with thickened stomach walls should undergo lower GI endoscopy to determine the diagnosis. There are no guidelines that will indicate which conditions require endoscopic evaluation.
Recent research found that thickened gastric walls were associated with a higher risk of developing gastric cancer than those with thinner walls. In a case report, 28 patients with gastric wall thickening on CT were evaluated by esophagogastroduodenoscopy. Only 10% of patients had symptoms of gastric cancer, while the remaining 11 had normal EGDs.
While the sensitivity, specificity, and negative predictive value of EUS are higher than those of CT scan, both procedures have significant risks. Endoscopic evaluation for stomach wall thickening using CT scan is expensive, labor-intensive, and carries a higher risk of complications. It can also delay diagnosis and treatment, so a good evaluation of wall thickness will reduce unnecessary endoscopic examinations. The authors declare there are no conflicts of interests.
A new study published by the European Society of Gastrointestinal Pathology suggests that EUS-guided biopsy may be possible in patients with suspected gastric thickening. Although the results were not clear, they show that EUS-guided biopsies can be used as an alternative to traditional biopsy. Although this diagnostic method is effective for patients with suspicions of malignancy, it has been limitedly studied.
Antral thickening can be caused by several factors. The most common factors are incomplete distention and gastric motility. These factors can be detected by MDCT images. They are measured by the electrical activity of the distal stomach. These contractions may contribute to additional thickening seen on a CT scan. These factors should be considered when deciding whether or not to proceed with endoscopic evaluation of thickening of the stomach wall.