ALGORITHM FOR EXAMINING PATIENTS WITH PATHOLOGY OF THE UPPER GASTROINTESTINAL TRACT USING MULTISPIRAL COMPUTED TOMOGRAPHY

Abstract

The aim of the study was to develop a technique for conducting multispiral computed tomography (MSCT) when examining the upper parts of the gastrointestinal tract. A prospective analysis of MSCT images was performed in 85 people who were examined at the AI "Republican Clinical Oncology Dispensary" under the Ministry of Public Health of the Chuvash Republic in 2015-2019. All patients underwent computed tomography using Light Speed VEX Plus and Light Speed RT 16 devices ("GE", USA) using our modified esophageal and gastric MSCT technique with an emphasis on the esophageal-gastric junction (EGJ). The characteristic quantitative MSCT-signs of the esophageal wall, the stomach, and the EGJ area in the norm, as well as the ones in an abnormal esophageal wall in esophagitis and gastritis are presented. The esophageal wall thickness in the normal condition and esophagitis was 3.12±0.69 mm and 8.16±1.65 mm (p = 0.000, R=0.909), and the maximum external diameter of the abdominal part of esophagus was 14.2±1.68 mm and 17.96±3.7 mm (p = 0.000, R = 0.579), respectively. The ROC analysis revealed a threshold value equal to 5.5 mm for distinguishing the wall thickness values characteristic for the unchanged esophagus and the esophagus with inflammatory pathology (sensitivity-96%, specificity-100%, p = 0.000). The threshold value for the external diameter of the abdominal esophageal segment was 17.5 mm (sensitivity – 64%, specificity – 100%, p = 0.000). The thickness of the stomach wall in the normal condition and in gastritis made 4.6±0.48 mm and 7.52±2.71 mm (p = 0.000, R = 0.673), respectively. At this, the threshold value of this characteristic was equal to 5.5 mm (sensitivity – 87.1%, specificity – 100%). The wall thickness in the area of the cardia in the normal condition was 5.4±1.01 mm, in presence of inflammation – 10.36±1.85 mm (p = 0.000, R = 0.858), the threshold value – 7.5 mm (sensitivity – 95.83%, specificity – 98.04%, p = 0.000). The thickness of individual layers in the unchanged stomach walls did not exceed 2 mm, the thickness of the mucosa was 1.01±0.11 mm.