Sonography of Gastrointestinal Tract Diseases

Ahn, Sung-Ho; Moon, Sun Young; Lee, Dong Hoon; Park, Seong Jin; Lim, Joo Won; Kim, Hyun Cheol; Lee, Han Na

doi:10.7863/ultra.15.09038

Cited by 8 publications

(2 citation statements)

References 31 publications

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“…The protocol for stomach examination performed upon fasting using oral contrast or double contrast-enhanced ultrasound (DCEUS) is equally complex (7,9,10,15,16,19–22) . The visualisation of this organ requires the use of different approaches (subcostal, intercostal), different positioning of the patient’s torso and performing the examination partly in a standing position.…”

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confidence: 99%

Pitfalls in ultrasound imaging of the stomach and the intestines

Smereczyński

Kołaczyk

2018

J Ultrason

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The gastrointestinal tract is an extraordinary human organ in terms of its morphology and function. Its complex structure and enormous length as well as frequent presence of gas discourage many doctors performing ultrasound examination from its exploration. Moreover, there are anatomical structures in multiple locations which can mimic certain abnormalities. It is difficult to present an exhaustive account of the problem of gastrointestinal tract ultrasound imaging errors in a single work; therefore, this study focuses mainly on false positive errors which usually result from a lack of knowledge of anatomical variants of the gastrointestinal tract structure. In the case of the stomach, rugae and muscle layer thickening towards the pylorus have been mentioned, which constitute variants of the structure of this organ examined when empty. Diagnostic pitfalls in the small intestine may include the dudenojejunal flexure (ligament of Treitz), the horizontal part of the duodenum and the ileocaecal valve. The status of the apparent lesions in all of the cases mentioned will be resolved following fluid intake by the patient. In the colon, the varied structure of semilunar folds should be taken note of. Their large thickness can warrant suspicion of wall invasion or a polyp. In addition, the study emphasises the importance of appropriate preparation of a patient for gastrointestinal tract examination since it determines the accuracy of the diagnosis. The authors also take note of common ‘sins’ of physicians such as hasty examination and failure to comply with the stomach and appendix examination protocol.

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confidence: 99%

Pitfalls in ultrasound imaging of the stomach and the intestines

Smereczyński

Kołaczyk

2018

J Ultrason

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“…The gastric contrast ultrasonography for healthy individuals can be distinguished into five distinct layers, which behave as "strongweak-strong-weak-strong" echo in sonograms. However, there remains controversy about the histological basis of each sonographic layer, especially the location of muscularis mucosae [3,4]. This study describes a "seven-layer stratification theory" of the gastric wall based on the histological and physical basis of ultrasonography and evaluates the clinical application value of this theory in the context of gastrointestinal disease.…”

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The seven-layer stratification theory of gastric wall under ultrasonography and its clinical application

Ke-xiao¹,

Qian²

2021

Preprint

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ObjectiveHere, we develop a seven-layer gastric wall stratification theory based on the physical basis of ultrasound and histology, and further discuss its potential clinical application. Methods1. Experimental methods: Ex vivo human gastric specimens were immersed in normal saline and examined with a high-frequency probe to study the relationship between the sonograms and the corresponding anatomy of the gastric wall. 2. The study enrolled 136 patients admitted to our hospital with gastric diseases who underwent gastric contrast ultrasonography supplemented with the pathological examination. The seven-layer stratification theory was adopted during the analysis to profile sonogram characteristics with lesions originating from various layers. ResultsAll the sonograms of the in vitro human gastric specimens could be divided into seven intervals of strong and weak echoes. The pathological examinations were performed on 136 patient-derived samples as the golden criteria of diagnosis: 29 cases of gastric polyps, 10 cases of lymphomas, 5 cases of neuroendocrine tumors, 11 cases of ectopic pancreas, 22 cases of gastric stromal tumor, 19 cases of leiomyomas, 29 cases of chronic inflammation, 9 cases of diffuse invasive cancer, and 2 cases of neurilemmoma. The ultrasound and pathological examination results were consistent in 110 cases, showing a coincidence rate of 80.9%. ConclusionBy adopting the seven-layer stratification theory of the gastric wall, the ultrasound can accurately locate the position of mucosal muscularis, which is of great significance for accurate measurement of the thickness of each anatomical layer and the correct judgment of the origin and the classification of the space-occupying lesions. Keywords Gastric wall; ultrasound; seven-layer stratification; clinical application

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