Gin-Chung Liu MD, Presenter: Nothing to Disclose

Chiao Yun Chen MD, Abstract Co-Author: Nothing to Disclose

Yu-Ting Kuo MD, Abstract Co-Author: Nothing to Disclose

Twei-Shiun Jaw MD, Abstract Co-Author: Nothing to Disclose

Jui-Sheng Hsu MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the efficacy of the multi-detector row CT(MDCT) in the differential diagnosis of giant gastric folds using 3D-morphologic volume rendening(VR) and multiplanar reformatted(MPR) images

We prospectively performed CT examinations using a 16-row MDCT scanner in 68 patients with giant gastric folds depicted by endoscopy. Six patients had Mẻnẻtrier disease,18 had acute gastric mucosal lesion(AGML),13 had gastric lymphoma, and 31 had scirrhous carcinoma.All patients were given 6g gas-producing crystals before unenhanced CT scan for VR images. They subsequently drank 800-1000ml water. Contrast-enhanced CT were acquired in the portal venous phase. VR and MRP images were then processed on a work station.We analyzed gastric morphology with VR images, and determined wall thickness, stratification, enhancement pattern and main thickened layer, perigastric conditions with MRP images. The Fisher protected least-significant-difference method was used to compare the gastric wall thickness among diseases.

Wall thickness of AGML was significantly(P<.05)less than that of Mẻnẻtrier, lymphoma and scirrhous carcinoma. In all patients with Mẻnẻtrier disease, MPR images revealed well-enhanced mucosal thickening with preservation of wall stratification. In all but one patients with gastric lymphoma, the main thickened layers included submucosa to serosa with preservation of the thin and well-enhanced mucosa layer. In all patients with scirrhous carcinoma, all layers of gastric wall were involved with perigastric infiltration.VR showed contour rigidity in scirrhous carcinoma, but pliant in other pathologies. Distinction of the diagnoses with our MDCT criteria, both the sensitivity and specificity for Mẻnẻtrier disease and AGML were 100%. The sensitivity and specificity for gastric lymphoma were 100%,97%;and 98%,100% respectively for scirrhous carcinoma.

MDCT using VR and MRP images can effectively differentiate different pathologies sharing common features of giant gastric folds on endoscopy.

We provide evidence to demonstrate that MDCT with 3D-VR and MRP images is able to differentiate various pathologies with giant gastric folds.

Liu, G, Chen, C, Kuo, Y, Jaw, T, Hsu, J, Differential Diagnosis of Giant Gastric Folds with Multidetector Row CT.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4436629.html