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KMID : 0386120000420020281
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Journal of the Korean Radiological Society
2000 Volume.42 No. 2 p.281 ~ p.285
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Helical CT Findings of Gastric Wall Thickening by Peptic Ulcer : Compared with Gastric Adenocarcinoma with Ulcer
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Jung Won-Jung
Choi Jong-Cheol
Seo Keum-Soo
Koo Bon-Sik
Park Byeong-Ho
Kim Chung-Keun
Lee Ki-Nam
Nam Kyung-Jin
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Abstract
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Purpose : To compare on the basis of helical CT findings gastric wall thickening of peptic gastric ulcer with that of gastric adenocarcinoma with ulcer.
Materials and Methods : Thirty-eight patients with pathologically proven gastric lesion [17 cases of peptic ulcer and 21 cases of ulcerative or ulceroinfiltrative gastric cancer(Borrman type Ⅱ, Ⅲ) underwent helical CT, and the findings were retrospectively reviewed in terms of maximum abnormal wall thickness, preservation of the inner enhancing layer, the presence of three discriminate layers of gastric wall, and enhancement pattern. The enhancement pattern of abnormally thick wall was compared with that of the portal phase of back muscle, and was defined as low, iso, or high. The Chi-square test and Student test were used for statistical analysis.
Results : In cases of peptic ulcer and gastric cancer with ulceration, maximum abnormal wall thickness was 7-30(mean. 16.1)mm, and 11-33(mean, 21.8)mm, respectively. The inner enhancing layer was preserved in 15 of 17 patients (88.2%) and one of 21(4.8%); three discriminate layers of gastric wall were observed in 8 of 17 patients(47.0%), and one of 21(4.8%). The enhancement pattern was low in 12 of 17 patients(70.5%), and 3 of 21(14.3%); iso in 4 of 17(23.5%), and 4 of 21 (19.0%), and high in one of 17(5.9%), and 14 of 21(66.7%). All figures refer, respectively, to the two distinct conditions. In terms of preservation of the inner enhancing layer, three discriminate layers of gastric wall,
and a low enhancement pattern, there were statistically significant differences between peptic ulcer and gastric adenocarcinoma with ulcer. Where the enhancements was high, however, the statistically significant difference between the two conditions was even greater. There was no statistically significant difference in terms of gastric wall thickness of iso-attenuation of thickened gastric.
Conclusion : Helical CT findings of gastric wall thickening, preservation of the inner enhancing layer, and three discriminate layers of gastric wall, as well as the nature of the observed enhancement pattern, may help differentiate between peptic ulcer and gastric adenocarcinoma with ulcer.
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KEYWORD
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Stomach CT, Stomach ulcer, Stomach neoplasms,
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