Increased Mucosal Thickness of the Stomach in Transabdominal Ultrasonogram: Correlation with Gastric Hemorrhage.

Kim,  Jun Young; Kim,  Dong Hyun; Ko,  Myoung Kwan; Byun,  Joo Nam; Kim,  Young Suk; Kim,  Young Chul; Oh,  Jae Hee

Journal of Korean Society of Medical Ultrasound 2000;19(3): 177-183.

Jun Young Kim, Dong Hyun Kim, Myoung Kwan Ko, Joo Nam Byun, Young Suk Kim, Young Chul Kim, Jae Hee Oh

Department of Diagnostic Radiology, College of Medicine, Chosun University.

Published online: January 1, 2001.

ABSTRACT

PURPOSE: The purpose of this study is to evaluate the role of transabdominal ultrasonography in predicting the he-morrhagic gastritis by the evaluation of gastric wall. MATERIALS AND METHODS: Transabdominal ultrasonographic assessment of gastric wall was performed 42 patients. Layers of gastric wall were preserved in all patients. Twenty-one patients whose gastric mucosa had diffuse thickening more than 5mm were classified as hypertrophic group. The other twenty-one patients whose gastric mucosa had thickness less than 5mm were classified as control group. In all 42 patients, endoscopic examina-tion was performed and the prevalence of gastric hemorrhage was recorded. The sensitivity, specificity, positive predictive value, and accuracy for predicting the hemorrhagic gastritis were calculated based on mucosal thick-ness. Sixteen patients who had been diagnosed as a hemorrhagic gastritis in the hypetrophic group on endoscop-ic examination were classified as a hemorrhagic group. The thickness of each layers in hemorrhagic and the control group were compared using t-test and Fisher's exact test. RESULTS: Using 5mm of mucosal thickness as a predictor, the sensitivity was 100%, the specificity was 80.8%, the positive predictive value was 76.2%, and the accuracy was 88.1%. Mean thickness of mucosa in hemorrhagic group and the control group were 9.6 +/- 1.6mm, and 1.4 +/- 0.4mm, respectively(p<0.01). Mean thickness of sub-mucosa was 1.1 +/- 0.3mm in hemorrhagic group and 0.6 +/- 0.3mm in control group(p<0.01). The submucosal layer was hyperechoic and well-defined in most control groups(18/21) while it was ill-defined and less echogenic in hemorrhagic group(p<0.01). CONCLUSION: The diagnosis of hemorrhagic gastritis can be suggested when there is diffuse thickening in the gas-tric mueosa shile submucosa layer shows decreased echogenicits and indistinct border. This may improve the value of sonographic evaluation.

Keywords: Stomach, US; Stomach, hemorrhage; Gastritis