Journal of Korean Society of Medical Ultrasound 1994;13(2): 109-115.
Ulrasonography of the obstructive lesions of the gastric outlet: Emphasis on the differentiation betweenadvanced gastric cancer and benign inflammato
Kyu Tong Yoh, Chang Hae Suh, Mi Young Kim, Soon Gu Cho, Chan Sup Park, Sang Kyoon Cho, Joon Mee Kim
Department of Radiology, Internal medicine1, Pathology2, College of Medicine, Inha University
This study was performed to evaluate the value of high resolution ultrsonography in the differential diagnosisof the obstructive lesions of the gastric outlet. We reviewed the ultrasonograms of 37 cases with symptoms ofgastric obstruction. The ultrasonograms were obtained by using 5 or 7.5 MHz probe. The pathology of the lesion wasconfirmed by operation or endoscopic biopsy in all cases. We analyzed the ultrasonograms in terms of the thicknessand length of the lesions, the ultrasonographic feature of the gastric lumen on transverse scan, the echogenicityof the lesion, and the changes in the 5 echo layers of the gastric wall. The average thickness of gastric cancerand inflammatory stricture was 18.4mm and 9.0mm, and that of length was 35.2mm and 11.5mm respectively. Thus, thethickness and length of the lesion in gastric cancers were significantly greater than those in inflammatorystrictures. On transverse scan, we classified the feature of lesion into 3 categories : marked circumferentialwall thickening with compressed slit like lumen, circumferential wall thickening with preserved round contour oflumen, and eccentrical wall thickening with peripheral deviation of lumen. Circumferential wall thickening withcentral slit like lumen and eccentrical wall thickening with displaced lumen were seen predominently in gastriccancers (48% and 44% respectively), while circumferential wall thickening with preserved round contour of lumen innflammatory strictures(80%). Gastric cancer showed low echogenicity in 22 cases (81%), whereas benign inflammationshowed low or iso echogenicity in equal number. Some or all of the 5 echo layers of the gastric wall wasdisintegrated in both groups. In summery, high resolution ultrasonography was heloful in determining the nature ofgastric outlet obstruction, especially in differentiation between advanced gastric cancer and inflammatorystricture.
Keywords: Pyloric obstruction, Pyloric ulcer, Gastric carcinoma, Stomach sonography
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