Wall thickening of the gastric antrum: is it a pseudolesion or a true tumorous condition?

초록

To evaluated the possibility of differential diagnosis between the true tumorous condition and the pseudo-wall thickening of the gastric antrum by analyzing two-phase spiral CT scan. Mean thickness of antral wall is 19mm in cancer group and 12.5mm in normal group. Thirty-one cases (51.6%) had concentric wall thickening and remainder had eccentric thickening in cancer group, wherease 51 cases (85.0%) had concentric thickening in normal group. The common enhancement patterns of thckened wall in cancer group were (1) thick enhanced innermost layer on arterial phase with diffusely enhanced whole wall thickness on venous phase (n=19),(2) thin enhanced innermost layer on arterial phase became iso-attenuation to poorly enhanced proper muscle layer on venous phase (n=16). In normal group, the common enhancement pattern was thin enhanced innermost layer on both arterial and venous phases (n=34). The common associated findings were regional lymphadenopathy (n=43) and food remnant in the stomach (n=15) in cancer group, and intraluminal normal folds at the thickened segment in normal group, (n=50). The findings of food remnant in the stomach despite overnight starvation and intraluminal normal folds were shown only in cases of cancer and normal group, respectively. Gastric cancer and pseudo-wall thickening of the gastric antrum can be differentiated by analyzing the findings of 2-phase spiral CT scan.