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KMID : 1149020190210010025
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Journal of Korean Society of Computed Tomographic Technology
2019 Volume.21 No. 1 p.25 ~ p.36
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The Effect of the Change in the Volume and the Wall Thickness of Stomach by Adjusting Dosage of Water According to Gender and Weight in Stomach CT
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Kim Yeong-Han
Nam Tae-Hyun
Kim Sung-Kwan
Chae Hee-Chang
Gwon Sun-Ahn
Dae Chang-Min
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Abstract
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Purpose: We tried to compare the changes of stomach volume size and wall thickness by changes of water amount, as an oral contrast agent, depending on each patient’s gender and weight in stomach CT for pre-operative evaluation of early gastric cancer.
Materials and Methods: In phantom study, three syringe phantoms(100 mL, 150 mL, 200 mL) filled with normal saline were scanned 10 times. Volumes of three phantoms were measured by 3D workstation to determine the accuracy and reproducibility of the measured values. In clinical study, 211 control subjects who ingested the certain amount of water according to the existing protocol(drinking same amount of water), and 194 subjects who ingested the amount of water adjusted according to one’s gender and weight, the volumes of water in stomach of them were measured by reconstructing the workstation and assessed stomach body and antral wall as quantitative analysis. Two independent observers evaluated expansion of the gastric on a 4-point scale method as a qualitative analysis.
Results: In phantom study, result of difference percentages of volume measurements were 0.007% (100 mL), 0.004% (150 mL) and 0.01% (200 mL). All phantom measurements were satisfied with standard tolerance ranges within ±5%. In clinical study, groups of male 60-70 kg, 70 to 80 kg and 80 kg or more in the experimental group, the amounts of remaining water in gastric were 7.5%, 37.9%, and 38 % increased more than the control group. The average thickness of the stomach walls in three groups were measured 0.27±0.01 mm, 0.20±1.30 mm, 0.09±0.35 mm thinner than the control group which shows better results for evaluate early gastric cancer. In qualitative analysis, points of 3 and 4 were increased in experimental group. Observer 1 gave 44.6% of points of 3 and 4 in the control group and 58.8% in the experimental group. Observer 2 gave 44.1% of points of 3 and 4 in the control group and 61.9% in the experiment group. Both evaluators gave high scores.
Conclusions: Changing amount of water agent depending on each patient’s gender and weight shows not only sufficient of remaining water in stomach but it also distends stomach wall which is easy to distinguish between early gastric cancer and advanced gastric cancer. Additionally, this protocol reduces burdens of drinking water because we set the appropriate amount of water by gender and weight following anatomically and physiologically.
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KEYWORD
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Stomach, Water, Weight, Gender
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