Spectrum of Lesions of the Gastric Antrum: Imaging characteristics. A Pictorial Guide.

Congress:

ECR 2020

Poster Number:

C-08050

Type:

Educational Exhibit

Keywords:

Not applicable, Neoplasia, Hyperplasia / Hypertrophy, Cancer, Contrast agent-intravenous, MR, CT, Stomach (incl. Oesophagus), Gastrointestinal tract, GI Tract

Authors:

M. Castillo Fortuño¹, A. Antolín Redondo¹, R. Mast Vilaseca¹, D. Eiroa², S. Castro¹, S. Landolfi¹, M. Alsina¹, D. Armario¹, J. Gornals¹; ¹Barcelona/ES, ²Santa Cruz de Tenerife/ES

DOI:

10.26044/ecr2020/C-08050

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-08050

Fig. 1: General anatomy of the stomach.

Fig. 2: Anatomical relations of the antrum.

Fig. 5: Differential diagnosis of the most important lesions that affect the antrum.

Fig. 6: Antral gastritis in contrast-enhanced CT (CECT) axial (A) and sagittal (C)...

Learning objectives

To review the most important and characteristic malignant and non-malignant entities affecting the antrum. To provide a basis to help differentiate the wide spectrum of diseases, focusing on the findings in computed tomography (CT) technique. To identify pitfalls during the differential diagnosis.

Background

The stomach is a muscular organ in the upper gastrointestinal tract that is divided into four portions (proximal to distal): cardia, fundus, body and pyloric portion. The antrum is a part of the pyloric portion located between the pyloric canal/pylorus and body (Fig. 1 Fig. 2). Multi-detector computed tomography (MDCT) is the main imaging technique used in the initial evaluation (both mural and extramural diseases). Endoscopic ultrasound is useful for studying the mucosa and tumors as it allows evaluation of locorregional lymphadenopathies and guided biopsy....

Findings and procedure details

1. INFLAMMATORY AND/OR INFECTIOUS DISEASES 1.1 Antral Gastritis Gastritis is the inflammation of the gastric mucosa (more frequent in the antrum) [1]. Can be classified depending causal agent causing the inflammation: non-erosive/atrophic gastritis (H. pylori) is the most common type [2]. It is presented as ahypodense wall thickening with submucosal edema and mucosal enhancement alongside diffuse gastric fold thickening (Fig. 6) [2]. 1.2 Antral Gastric Ulcer Defect in the mucosa that extends up to muscularis mucosae and beyond (90% in the lesser curvature and posterior...

Conclusion

CT is a suitable and sensitive imaging technique to evaluate the antrum. Diseases affecting the antrum have a great variety of radiological findings. Differentiate malignant from non-malignant lesions and avoid possible pitfalls. Multidisciplinary approach is needed, as imaging per se is rarely diagnostic.

Personal information and conflict of interest

M. Castillo Fortuño; Barcelona/ES - nothing to disclose A. Antolín Redondo; Barcelona/ES - nothing to disclose R. Mast Vilaseca; Barcelona/ES - nothing to disclose D. Eiroa Gutiérrez; Santa Cruz de Tenerife, SPAIN/ES - nothing to disclose S. Castro; Barcelona/ES - nothing to discloseS. Landolfi; Barcelona/ES - nothing to discloseM. Alsina; Barcelona/ES - nothing to discloseD. Armario; Barcelona/ES - nothing to discloseJ. Gornals; Barcelona/ES - nothing to disclose

References

Ba-Ssalamah A, Prokop M,et al. Dedicated multidetector CT of the stomach: spectrum of diseases. Radiographics. 2003 May-Jun;23(3):625-44. Nagpal P, Prakash A, et al. MDCT imaging of the stomach: advances and applications. Br J Radiol. 2017 Jan;90(1069):20160412. Review. Virmani V, Khandelwal A, et al. Neoplastic stomach lesions and their mimickers: spectrum of imaging manifestations. Cancer Imaging. 2012 Aug 10;12:269-78. Mottet C, Juillerat P, et al. Upper gastrointestinal Crohn's disease. Digestion. 2007;76(2):136-40. Oh JY, Nam KJ et al. Benign submucosal lesions of the stomach and duodenum: imaging...