DOI: 10.1148/rg.231025071
Current Role of CT in Imaging of the Stomach1
Karen M. Horton, MD and
Elliot K. Fishman, MD
1 From the Department of Radiology, Johns Hopkins Medical Institutions, 601 N Caroline St, Rm 3251, Baltimore, MD 21287. Recipient of a Certificate of Merit award for an education exhibit at the 2001 RSNA scientific assembly. Received April 1, 2002; revision requested May 13 and received June 11; accepted June 12. Address correspondence to E.K.F. (e-mail: efishman@jhmi.edu).
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Figure 1. Contrast material-enhanced CT scan obtained with water as an oral contrast agent demonstrates the normal appearance of the stomach. The enhancing gastric wall is well visualized because it is between the intraluminal water and the extragastric fat.
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Figure 2. Coronal contrast-enhanced 3D volume-rendered multidetector row CT scan obtained with water as an oral contrast agent demonstrates the normal appearance of the stomach.
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Figure 3a. Coronal (a), axial (b), and sagittal (c) multiplanar reformatted images obtained in a patient with gastric cancer all demonstrate the mass (arrow).
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Figure 3b. Coronal (a), axial (b), and sagittal (c) multiplanar reformatted images obtained in a patient with gastric cancer all demonstrate the mass (arrow).
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Figure 3c. Coronal (a), axial (b), and sagittal (c) multiplanar reformatted images obtained in a patient with gastric cancer all demonstrate the mass (arrow).
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Figure 4a. Coronal contrast-enhanced 3D volume-rendered multidetector row CT scans obtained in a patient with gastric cancer depict the mass (arrow). With most 3D software, the imaging parameters (transparency, window width and level) can be altered to change the appearance of the gastric wall and intraluminal water. This capability may help highlight a particular disease. The indistinctness of the wall of the greater curvature of the stomach in b is due to the use of an oblique clip plane.
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Figure 4b. Coronal contrast-enhanced 3D volume-rendered multidetector row CT scans obtained in a patient with gastric cancer depict the mass (arrow). With most 3D software, the imaging parameters (transparency, window width and level) can be altered to change the appearance of the gastric wall and intraluminal water. This capability may help highlight a particular disease. The indistinctness of the wall of the greater curvature of the stomach in b is due to the use of an oblique clip plane.
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Figure 5. Three-dimensional endoluminal image of the stomach obtained in a patient with gastritis demonstrates moderate diffuse fold thickening.
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Figure 6a. (a) Coronal contrast-enhanced 3D volume-rendered CT scan obtained in a patient with gastric cancer demonstrates segmental wall thickening (arrows). (b) Axial CT scan obtained in the same patient reveals invasion of the anterior abdominal wall by the mass (arrowhead).
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Figure 6b. (a) Coronal contrast-enhanced 3D volume-rendered CT scan obtained in a patient with gastric cancer demonstrates segmental wall thickening (arrows). (b) Axial CT scan obtained in the same patient reveals invasion of the anterior abdominal wall by the mass (arrowhead).
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Figure 7a. Coronal (a) and axial oblique (b) contrast-enhanced 3D volume-rendered CT scans obtained in a patient with gastric cancer demonstrate focal thickening of the pylorus and distal antrum (arrow).
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Figure 7b. Coronal (a) and axial oblique (b) contrast-enhanced 3D volume-rendered CT scans obtained in a patient with gastric cancer demonstrate focal thickening of the pylorus and distal antrum (arrow).
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Figure 8. Axial oblique contrast-enhanced 3D volume-rendered CT scan obtained in a patient with gastric cancer reveals focal thickening of the pylorus (arrows) that results in gastric outlet obstruction.
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Figure 9. Contrast-enhanced CT scan obtained with water as an oral contrast agent demonstrates subtle segmental thickening of the gastric antrum (arrow). Endoscopic biopsy revealed gastric lymphoma.
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Figure 10. Contrast-enhanced CT scan obtained with water as an oral contrast agent demonstrates segmental thickening of the stomach (arrows), a finding that represents gastric lymphoma.
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Figure 11. Coronal oblique contrast-enhanced 3D volume-rendered CT scan demonstrates a smooth gastric mass in the antrum (arrow). The mass proved to be a benign GIST at surgery.
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Figure 12a. Sagittal (a) and axial oblique (b) contrast-enhanced 3D volume-rendered CT scans demonstrate a round, 5-cm exophytic mass (arrows) that arises from the stomach. The mass proved to be a benign GIST at surgery.
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Figure 12b. Sagittal (a) and axial oblique (b) contrast-enhanced 3D volume-rendered CT scans demonstrate a round, 5-cm exophytic mass (arrows) that arises from the stomach. The mass proved to be a benign GIST at surgery.
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Figure 13. Coronal contrast-enhanced 3D volume-rendered CT scan demonstrates a large, ulcerating exophytic mass (arrows) that arises from the stomach, a finding that is compatible with a malignant GIST.
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Figure 14a. Coronal (a) and endoluminal (b) contrast-enhanced 3D volume-rendered CT scans demonstrate moderate fold and wall thickening, findings that are compatible with gastritis.
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Figure 14b. Coronal (a) and endoluminal (b) contrast-enhanced 3D volume-rendered CT scans demonstrate moderate fold and wall thickening, findings that are compatible with gastritis.
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Figure 15. Coronal contrast-enhanced 3D volume-rendered CT scan demonstrates H pylori gastritis, which causes segmental fold thickening (arrow) along the greater curvature of the stomach, thereby simulating a tumor.
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Figure 16a. Coronal (a) and coronal oblique (b) contrast-enhanced 3D volume-rendered CT scans reveal circumferential thickening of the pylorus, a finding that was suspicious for cancer. Partial gastrectomy revealed adult hypertrophic pyloric stenosis, which was thought to result from chronic peptic ulcer disease.
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Figure 16b. Coronal (a) and coronal oblique (b) contrast-enhanced 3D volume-rendered CT scans reveal circumferential thickening of the pylorus, a finding that was suspicious for cancer. Partial gastrectomy revealed adult hypertrophic pyloric stenosis, which was thought to result from chronic peptic ulcer disease.
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Figure 17a. (a) Coronal contrast-enhanced 3D volume-rendered CT scan obtained in a patient with pancreatic cancer reveals a mass (straight arrow) that causes obstruction of the splenic vein (curved arrow). (b) CT angiogram obtained in the same patient demonstrates multiple large gastric varices.
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Figure 17b. (a) Coronal contrast-enhanced 3D volume-rendered CT scan obtained in a patient with pancreatic cancer reveals a mass (straight arrow) that causes obstruction of the splenic vein (curved arrow). (b) CT angiogram obtained in the same patient demonstrates multiple large gastric varices.
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Figure 18a. Sagittal (a) and axial oblique (b) volume-rendered CT angiograms demonstrate the normal anatomy of the celiac axis. The left gastric artery (arrow) is seen to arise from the celiac axis.
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Figure 18b. Sagittal (a) and axial oblique (b) volume-rendered CT angiograms demonstrate the normal anatomy of the celiac axis. The left gastric artery (arrow) is seen to arise from the celiac axis.
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Figure 19. Volume-rendered CT angiogram demonstrates a normal anatomic variant. The left gastric artery (arrow) is seen to supply the left hepatic lobe.
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Copyright © 2003 by the Radiological Society of North America.
